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Individual
VINCENT COLOSIMO
Active
Individual
VINCENT COLOSIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4547T
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001264970
—
PA
01
—
100507579
HENDERSON OFFICE MEDICAID#
NV
01
—
100510914
RENO OFFICE MEDICAID#
NV
01
—
100511621
CARSON CITY OFFICE MEDICAID#
NV
01
—
100511622
SPARKS OFFICE MEDICAID#
NV
01
—
100511623
TROPICAL PKWY OFFICE MEDICAID#
NV
01
—
100511624
SMOKE RANCH RD OFFICE MEDICAID#
NV
01
—
100511625
NELLIS BLVD OFFICE MEDICAID#
NV
Enumeration date
04/13/2006
Last updated
06/25/2008
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