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NPI Code Detail

MEDICARE: DR. AMIE K NICOLA DMD

MEDICARE:  DR. AMIE K NICOLA  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry049558NY
21223G0001XGeneral Practice Dentistry15383MD

General Provider Information

NPI Number : 1114141728
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMIE K NICOLA DMD
Provider Business Mailing Address
First Line : 23 BEARBERRY RD
Second Line :
City : BERLIN
State : MD
Zip : 21811-2049
Country : US
Telephone Number : 607-382-7146
Fax Number :
Provider Business Practice Location Address
First Line : 14203 COASTAL HWY STE 1
Second Line :
City : OCEAN CITY
State : MD
Zip : 21842-7414
Country : US
Telephone Number : 410-250-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 04/17/2015

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Directions to “ DR. AMIE K NICOLA DMD” Practice Location

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