Organization
NEW MILLENNIUM DENTALCARE INC
Active
Other names
Nationwide Dental Plan
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL JOHN GILLICH JR. (CEO/DENTAL DIRECTOR)
(732) 286-0336
Entity
Organization
Contact information
Practice address
1805 N 6TH AVE, ROOM 12, PENSACOLA, FL 32503-4518
(732) 286-0336
(732) 286-0454
Mailing address
PO BOX 11155, PENSACOLA, FL 32524-1155
(732) 286-0336
(732) 286-0454
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/07/2010
Last updated
10/26/2010
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