| Nicholas Frandy Gardner | |
|
119 E Main St Gouverneur NY 13642-1712 | |
| () - | |
| Not Available |
| Full Name | Nicholas Frandy Gardner |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 119 E Main St, Gouverneur, New York |
| Authorized Official Name and Position | Nicholas Gardner (OWNER) |
| Authorized Official Contact | 3152877900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Frandy Gardner 119 E Main St Gouverneur NY 13642-1712 Ph: (315) 287-7900 | Nicholas Frandy Gardner 119 E Main St Gouverneur NY 13642-1712 Ph: () - |
| NPI Number | 1811514508 |
|---|---|
| Provider Enumeration Date | 06/29/2020 |
| Last Update Date | 06/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811514508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Gouverneur Dental Associates, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 354 E Main St, Gouverneur, NY 13642 Phone: 315-287-4000 Fax: 315-287-4109 |