Provider Demographics
NPI:1902350218
Name:DR RAMON F ORTIZ DMDMS PA
Entity Type:Organization
Organization Name:DR RAMON F ORTIZ DMDMS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:F
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-784-0929
Mailing Address - Street 1:301 WOODLANDS PKWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2033
Mailing Address - Country:US
Mailing Address - Phone:727-784-0929
Mailing Address - Fax:
Practice Address - Street 1:301 WOODLANDS PKWY
Practice Address - Street 2:SUITE 6
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-2033
Practice Address - Country:US
Practice Address - Phone:727-784-0929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty