Individual
VICKI A NIDZGORSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
1105 E KENNEDY BLVD, TAMPA, FL 33602-3511
(813) 330-7801
(813) 276-2999
Mailing address
PO BOX 5135, TAMPA, FL 33675-5135
(813) 330-7801
(813) 276-2999
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH19889
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH19889
LICENSE
FL
Enumeration date
03/25/2010
Last updated
03/25/2010
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