Provider Demographics
NPI:1396541660
Name:POLY DA ROCHA, ANE (DDS, MSC, PHD)
Entity type:Individual
Prefix:DR
First Name:ANE
Middle Name:
Last Name:POLY DA ROCHA
Suffix:
Gender:F
Credentials:DDS, MSC, PHD
Other - Prefix:DR
Other - First Name:ANE
Other - Middle Name:
Other - Last Name:POLY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MSC, PHD
Mailing Address - Street 1:PO BOX 100405
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 100405
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0405
Practice Address - Country:US
Practice Address - Phone:352-273-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics