Individual
GINA M NICOLOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3120 MAHAN DRIVE, TALLAHASSEE, FL 32308
(217) 540-5100
(877) 635-3298
Mailing address
3120 MAHAN DRIVE, TALLAHASSEE, FL 32308
(217) 540-5100
(877) 635-3298
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN22618
FL
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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