Healthcare Provider Details

I. General information

NPI: 1518852037
Provider Name (Legal Business Name): NICOLE C BIFARETTI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 MEDWAY RD STE 2&3
MILFORD MA
01757-2932
US

IV. Provider business mailing address

3431 MELISSA CT
PORT CHARLOTTE FL
33980-2265
US

V. Phone/Fax

Practice location:
  • Phone: 781-325-1091
  • Fax:
Mailing address:
  • Phone: 941-286-9764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001023
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: