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Individual
SHARLETTE NICOLE VICTORINO
Active
Individual
SHARLETTE NICOLE VICTORINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
014483
GA
1223G0001X
General Practice Dentistry
Primary
12012074A
IN
1223G0001X
General Practice Dentistry
8589
KY
1223G0001X
General Practice Dentistry
8665
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
EPSDT
KY
05
—
1223G0001X
—
KY
Enumeration date
06/26/2007
Last updated
01/22/2014
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