# NICHOLAS FRANDY GARDNER

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

## Provider details

- **NPI number:** 1811514508
- **Authorized official:** NICHOLAS GARDNER DDS (OWNER)
- **Authorized official phone:** (315) 287-7900

## Contact information

- **Practice address:** 119 E MAIN ST, GOUVERNEUR, NY 13642-1712
- **Mailing address:** 119 E MAIN ST, GOUVERNEUR, NY 13642-1712
- **Mailing address phone:** (315) 287-7900
- **Mailing address fax:** (315) 287-4789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2020
- **Last updated:** 06/29/2020