Provider Demographics
NPI:1881775435
Name:OCHOA, ENRIQUE M (DDS)
Entity type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:M
Last Name:OCHOA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 DEL PRADO BLVD #209
Mailing Address - Street 2:CAPE CORAL
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904
Mailing Address - Country:US
Mailing Address - Phone:239-549-7644
Mailing Address - Fax:501-635-0386
Practice Address - Street 1:3501 DEL PRADO BLVD
Practice Address - Street 2:#209
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904
Practice Address - Country:US
Practice Address - Phone:239-549-7644
Practice Address - Fax:501-635-0386
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 12765122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist