# CITRUS ORAL AND FACIAL SURGERY AT OCALA, LLC

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

## Provider details

- **NPI number:** 1326535279
- **Authorized official:** MRS. MISTY C BLOMBERG (OFFICE MANAGER)
- **Authorized official phone:** (522) 509-6500

## Contact information

- **Practice address:** 6129 W CORPORATE OAKS DR, CRYSTAL RIVER, FL 34429-8732
- **Practice address phone:** (352) 795-4994
- **Practice address fax:** (352) 795-4609
- **Mailing address:** 2611 SE 17TH ST STE A, OCALA, FL 34471-5587
- **Mailing address phone:** (352) 509-6500
- **Mailing address fax:** (352) 509-6556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN17708 | FL | Yes |

## Other

- **Enumeration date:** 04/17/2018
- **Last updated:** 06/21/2023