# CAROL ANN D. NICROSI DMD, MS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235227828
- **Authorized official:** DR. CAROL ANN NICROSI DMD (DENTIST)
- **Authorized official phone:** (205) 631-4572

## Contact information

- **Practice address:** 1324 MAIN ST, GARDENDALE, AL 35071
- **Practice address phone:** (205) 631-4572
- **Practice address fax:** (205) 631-4979
- **Mailing address:** 1324 MAIN ST., P.O. BOX 908, GARDENDALE, AL 35071
- **Mailing address phone:** (205) 631-4572
- **Mailing address fax:** (205) 631-4979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3725 | AL | — |
| 1223P0221X | Pediatric Dentistry | 4725 | AL | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 515-06005 | BCBS PROVIDER \# | AL |
| 01 | — | 51505999 | BCBS PROVDIER \# | AL |