Provider Demographics
NPI:1790990067
Name:MITCHELL-TOTH, NICOLE E (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:E
Last Name:MITCHELL-TOTH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19651 BRUCE B DOWNS BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2438
Mailing Address - Country:US
Mailing Address - Phone:813-957-5887
Mailing Address - Fax:813-971-8064
Practice Address - Street 1:19651 BRUCE B DOWNS BLVD STE A1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2438
Practice Address - Country:US
Practice Address - Phone:813-957-5887
Practice Address - Fax:813-971-8064
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist