Provider Demographics
NPI:1861157711
Name:HEBRON DENTAL, INC
Entity type:Organization
Organization Name:HEBRON DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-890-9517
Mailing Address - Street 1:1100 CESERY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5699
Mailing Address - Country:US
Mailing Address - Phone:800-915-0906
Mailing Address - Fax:
Practice Address - Street 1:1100 CESERY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5699
Practice Address - Country:US
Practice Address - Phone:800-915-0906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty