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General NPI Number Information
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NPI Number | 1174227417
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Entity Type | Individual
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Provider Name | NICOLE ORIANA MANFRINI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 204 W HILL BLVD
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City | CHARLESTON AFB
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State | SC
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Zip | 29404-4704
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Country | US
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Telephone | 843-963-6836
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Fax |
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Provider Business Mailing Address
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Address Line | 11118 NW 80TH LN
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City | MIAMI
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State | FL
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Zip | 33178-6008
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Country | US
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Telephone | 786-247-0453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28396
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License Number State | FL
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