Individual
DR. NICOLE ELENI MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-3553
Mailing address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-3553
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
052299
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02683365
—
NY
Enumeration date
10/02/2006
Last updated
08/20/2014
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