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General NPI Number Information
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NPI Number | 1235227828
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Entity Type | Organization
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Legal Business Name | CAROL ANN D. NICROSI DMD, MS, PC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1324 MAIN ST
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City | GARDENDALE
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State | AL
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Zip | 35071
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Country | US
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Telephone | 205-631-4572
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Fax | 205-631-4979
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Provider Business Mailing Address
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Address Line | 1324 MAIN ST. P.O. BOX 908
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City | GARDENDALE
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State | AL
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Zip | 35071
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Country | US
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Telephone | 205-631-4572
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Fax | 205-631-4979
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CAROL ANN NICROSI
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Credential | DMD
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Telephone | 205-631-4572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3725
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 4725
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License Number State | AL
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