Ocoee Dental Care PLLC
Clinic/Center, Dental in Cleveland, TN. Organization (NPI-2).
NPI number1255043618
StatusActive
Last updated in NPPESFeb 28, 2024
Details
- NPI
- 1255043618
- Entity type
- Organization (NPI-2)
- Legal business name
- Ocoee Dental Care PLLC
- Organization subpart
- No
- Enumeration date
- Dec 16, 2022
- Certification date
- Feb 28, 2024
- Last updated
- Feb 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
64 Mouse Creek Rd NwCleveland, TN 37312-4800
Phone 423-790-1311
Mailing address
64 Mouse Creek Rd NwCleveland, TN 37312-4800
Phone 423-790-1311
Authorized official
An Ta
Manager
8587745663
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