Provider Demographics
NPI:1538410444
Name:PATRICIA NICOLOSI DDS
Entity type:Organization
Organization Name:PATRICIA NICOLOSI DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-488-1388
Mailing Address - Street 1:5161 E ARAPAHOE RD
Mailing Address - Street 2:SUIT #310
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2387
Mailing Address - Country:US
Mailing Address - Phone:720-488-1388
Mailing Address - Fax:720-488-1242
Practice Address - Street 1:5161 E ARAPAHOE RD
Practice Address - Street 2:SUIT #310
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2387
Practice Address - Country:US
Practice Address - Phone:720-488-1388
Practice Address - Fax:720-488-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty