Individual
DR. NICOLE M MANCINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2151 CENTURY LN, JOHNSON CITY, TN 37604
(423) 929-6941
(423) 929-6972
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 433-6057
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10919
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q047672
—
TN
Enumeration date
05/02/2007
Last updated
06/20/2019
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