Gina Nicoloso Dmd Pllc

NPI #1922869338 in Hawthorne, Florida

Provider Information

NPI Number: 1922869338
Entity Type: Organization
Organization Name: Gina Nicoloso Dmd Pllc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jan 22, 2024
Last Updated: Jan 22, 2024

Practice Location

Address: 6605 SE 221ST ST
City: Hawthorne
State: Florida
ZIP Code: 32640-3815
Phone: (352) 481-2741

Authorized Official

Name: GINA NICOLOSO
Title: OWNER
Phone: (850) 509-9465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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