Individual
RICARDO M ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3665 COOLIDGE CT STE 102, TALLAHASSEE, FL 32311-7894
(850) 431-6725
(850) 431-6859
Mailing address
3665 COOLIDGE CT STE 102, TALLAHASSEE, FL 32311-7894
(850) 431-6725
(850) 431-6859
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN23064
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D-10615
MA
Other
Enumeration date
07/08/2009
Last updated
06/04/2021
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