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Organization
FACULTY ASSOCIATES, INC
Active
Organization
FACULTY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODRIGO NEIVA D.D.S. (PERIODONTOLOGY PROGRAM DIRECTOR)
(352) 273-7846
Entity
Organization
Contact information
Practice address
1395 CENTER DR, GAINESVILLE, FL 32610-3006
(352) 273-7846
Mailing address
PO BOX 100425, GAINESVILLE, FL 32610-0425
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN-22055
FL
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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