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General NPI Number Information
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NPI Number | 1265272801
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Entity Type | Individual
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Provider Name | ELIZABETH MARY NOLAN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 11157 N 56TH ST
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2901
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Country | US
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Telephone | 813-641-4921
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Fax |
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Provider Business Mailing Address
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Address Line | 12701 S 82ND AVE
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City | PALOS PARK
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State | IL
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Zip | 60464-2015
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Country | US
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Telephone | 708-712-0692
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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 | 29702
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | DN29702
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License Number State | FL
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