Organization
GINA NICOLOSO DMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA NICOLOSO (OWNER)
(850) 509-9465
Entity
Organization
Contact information
Practice address
6605 SE 221ST ST, HAWTHORNE, FL 32640-3815
(352) 481-2741
(352) 481-5341
Mailing address
6605 SE 221ST ST, HAWTHORNE, FL 32640-3815
(352) 481-2741
(352) 481-5341
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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