Provider Demographics
NPI:1801999743
Name:NICOLOSI, PATRICIA MARIA (DDS PC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MARIA
Last Name:NICOLOSI
Suffix:
Gender:F
Credentials:DDS PC
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Mailing Address - Street 1:5161 E ARAPAHOE RD
Mailing Address - Street 2:SUITE #310
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2387
Mailing Address - Country:US
Mailing Address - Phone:720-488-1388
Mailing Address - Fax:720-488-1242
Practice Address - Street 1:5161 E ARAPAHOE RD
Practice Address - Street 2:SUITE #310
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2387
Practice Address - Country:US
Practice Address - Phone:720-488-1388
Practice Address - Fax:720-488-1242
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO81651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21679533Medicaid