Individual
VINCENT COLOSIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2811 N GREEN VALLEY PKWY, HENDERSON, NV 89014-0401
(702) 434-2219
(702) 456-6160
Mailing address
926 GREAT POND DR, SUITE 2003, ALTAMONTE SPRINGS, FL 32714-7244
(407) 772-5124
(407) 788-3572
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4547T
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001264970
—
PA
01
—
100507579
HENDERSON OFFICE MEDICAID#
NV
01
—
100510914
RENO OFFICE MEDICAID#
NV
01
—
100511621
CARSON CITY OFFICE MEDICAID#
NV
01
—
100511622
SPARKS OFFICE MEDICAID#
NV
01
—
100511623
TROPICAL PKWY OFFICE MEDICAID#
NV
01
—
100511624
SMOKE RANCH RD OFFICE MEDICAID#
NV
01
—
100511625
NELLIS BLVD OFFICE MEDICAID#
NV
Enumeration date
04/13/2006
Last updated
06/25/2008
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