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General NPI Number Information
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NPI Number | 1275988644
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Entity Type | Organization
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Legal Business Name | NICHOLAS TUCCI, DMD, PC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 800 COMMUNITY DR SUITE #305
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City | MANHASSET
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State | NY
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Zip | 11030-3822
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Country | US
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Telephone | 516-466-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 800 COMMUNITY DRIVE SUITE #305
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City | MANHASSET
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State | NY
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Zip | 11030
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Country | US
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Telephone | 516-466-0053
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Fax |
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Authorized Official
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Title or Position | DENTIST / OWNER
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Name | DR. NICHOLAS C. TUCCI
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Credential | DMD
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Telephone | 516-466-0053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 040740
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License Number State | NY
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