# NEW MILLENNIUM DENTALCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nationwide Dental Plan
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033426473
- **Authorized official:** MR. PAUL JOHN GILLICH JR. (CEO/DENTAL DIRECTOR)
- **Authorized official phone:** (732) 286-0336

## Contact information

- **Practice address:** 1805 N 6TH AVE, ROOM 12, PENSACOLA, FL 32503-4518
- **Practice address phone:** (732) 286-0336
- **Practice address fax:** (732) 286-0454
- **Mailing address:** PO BOX 11155, PENSACOLA, FL 32524-1155
- **Mailing address phone:** (732) 286-0336
- **Mailing address fax:** (732) 286-0454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2010
- **Last updated:** 10/26/2010