# OCOEE DENTAL CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255043618
- **Authorized official:** DR. AN TA DMD (MANAGER)
- **Authorized official phone:** (858) 774-5663

## Contact information

- **Practice address:** 64 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4800
- **Practice address phone:** (423) 790-1311
- **Mailing address:** 64 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4800
- **Mailing address phone:** (423) 790-1311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2022
- **Last updated:** 02/28/2024