Individual
DR. CLEO BIANCA VIDICAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-5564
(352) 273-6695
(352) 294-5310
Mailing address
PO BOX 100414, GAINESVILLE, FL 32610-0414
(352) 273-6695
(352) 294-5310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11848
TN
122300000X
Dentist
25780
MT
122300000X
Dentist
2901600790
MI
122300000X
Dentist
D13261
MN
1223X0008X
Oral and Maxillofacial Radiology Dentistry
11848
TN
1223X0008X
Oral and Maxillofacial Radiology Dentistry
25780
MT
1223X0008X
Oral and Maxillofacial Radiology Dentistry
2901600790
MI
1223X0008X
Oral and Maxillofacial Radiology Dentistry
D13261
MN
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
DN23503
FL
Other
Enumeration date
07/17/2013
Last updated
02/29/2024
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