Provider Demographics
NPI:1710549324
Name:GNF DENTAL GROUP, P.A.
Entity Type:Organization
Organization Name:GNF DENTAL GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NOLVERIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FROMETA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:321-354-5221
Mailing Address - Street 1:2300 DEER CREEK COMMERCE LN STE 500
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6848
Mailing Address - Country:US
Mailing Address - Phone:863-420-4130
Mailing Address - Fax:
Practice Address - Street 1:2300 DEER CREEK COMMERCE LN STE 500
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6848
Practice Address - Country:US
Practice Address - Phone:863-420-4130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty