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Organization
PARK DENTAL OF OCALA, PA
Active
Organization
PARK DENTAL OF OCALA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER A LARSON DMD (CEO)
(352) 861-2510
Entity
Organization
Contact information
Practice address
3101 SW 34TH AVE STE 600, OCALA, FL 34474-8476
(352) 861-2510
(352) 861-2498
Mailing address
3101 SW 34TH AVE STE 600, OCALA, FL 34474-8476
(352) 861-2510
(352) 861-2498
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18061
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077927000
—
FL
01
—
1902005903
INDIVIDUAL NPI FOR DR LARSON
FL
Enumeration date
08/31/2009
Last updated
08/31/2009
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