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Organization
ORTEGA RIVER DENTISTRY
Active
Organization
ORTEGA RIVER DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINH TRUONG (DMD/ OWNER)
(904) 864-2222
Entity
Organization
Contact information
Practice address
5911 TIMUQUANA RD STE 202, JACKSONVILLE, FL 32210-8174
(904) 864-2222
Mailing address
5911 TIMUQUANA RD STE 202, JACKSONVILLE, FL 32210-8174
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19050
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012642300
—
FL
Enumeration date
01/06/2016
Last updated
01/06/2016
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