Provider Demographics
NPI:1710553144
Name:GABRIELE, NICOLA A (DDS)
Entity Type:Individual
Prefix:MISS
First Name:NICOLA
Middle Name:A
Last Name:GABRIELE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1257
Mailing Address - Country:US
Mailing Address - Phone:614-829-7703
Mailing Address - Fax:614-829-6799
Practice Address - Street 1:107 W COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1257
Practice Address - Country:US
Practice Address - Phone:614-829-7703
Practice Address - Fax:614-829-6799
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026468122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist