Provider Demographics
NPI:1952622862
Name:GUTIERREZ, RAMON LUIS JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LUIS
Last Name:GUTIERREZ
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:8075 SW HIGHWAY 200
Mailing Address - Street 2:SUITE 114
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-7823
Mailing Address - Country:US
Mailing Address - Phone:352-237-3008
Mailing Address - Fax:
Practice Address - Street 1:8075 SW HIGHWAY 200
Practice Address - Street 2:SUITE 114
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7823
Practice Address - Country:US
Practice Address - Phone:352-237-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist