| Gina Nicoloso Dmd Pllc | |
|
6605 Se 221st St Hawthorne FL 32640-3815 | |
| (352) 481-2741 | |
| (352) 481-5341 |
| Full Name | Gina Nicoloso Dmd Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6605 Se 221st St, Hawthorne, Florida |
| Authorized Official Name and Position | Gina Nicoloso (OWNER) |
| Authorized Official Contact | 8505099465 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gina Nicoloso Dmd Pllc 6605 Se 221st St Hawthorne FL 32640-3815 Ph: (352) 481-2741 | Gina Nicoloso Dmd Pllc 6605 Se 221st St Hawthorne FL 32640-3815 Ph: (352) 481-2741 |
| NPI Number | 1922869338 |
|---|---|
| Provider Enumeration Date | 01/22/2024 |
| Last Update Date | 01/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922869338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Gator Dental Associates, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6605 Se 221st St, Hawthorne, FL 32640 Phone: 352-481-2741 Fax: 352-481-5341 |