DR. Nicole Provenzano, DDS

NPI #1952591661 in Astoria, New York

Provider Information

NPI Number: 1952591661
Entity Type: Individual
Name: DR. Nicole Provenzano, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 29, 2007
Last Updated: Nov 16, 2016

Practice Location

Address: 3156 STEINWAY ST
City: Astoria
State: New York
ZIP Code: 11103-3909
Phone: (718) 721-4700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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