Provider Demographics
NPI:1245499573
Name:GERMAN, IGOR (DMD)
Entity type:Individual
Prefix:DR
First Name:IGOR
Middle Name:
Last Name:GERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5481 SW 60TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7698
Mailing Address - Country:US
Mailing Address - Phone:352-653-3161
Mailing Address - Fax:352-237-0039
Practice Address - Street 1:809 HIGHWAY 466 STE C-102
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3909
Practice Address - Country:US
Practice Address - Phone:352-336-8478
Practice Address - Fax:352-775-1727
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN182681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice