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General NPI Number Information
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NPI Number | 1871874818
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Entity Type | Individual
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Provider Name | ELIZABETH NOCHIMSON
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Gender | Female
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Dates
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Enumeration Date | 09/05/2011
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 777 DELTONA BLVD STE 9
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City | DELTONA
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State | FL
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Zip | 32725-7174
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Country | US
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Telephone | 386-574-4407
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Fax |
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Provider Business Mailing Address
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Address Line | 3005 FALLING ACORN CIR
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City | LAKE MARY
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State | FL
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Zip | 32746-4743
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Country | US
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Telephone | 954-560-3792
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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 | DN19458
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License Number State | FL
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