Full Name | Nicholas Frandy Gardner |
---|---|
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 119 E Main St, Gouverneur, New York |
Authorized Official Name and Position | Nicholas Gardner (OWNER) |
Authorized Official Contact | 3152877900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Nicholas Frandy Gardner 119 E Main St Gouverneur NY 13642-1712 Ph: (315) 287-7900 | Nicholas Frandy Gardner 119 E Main St Gouverneur NY 13642-1712 Ph: () - |
NPI Number | 1811514508 |
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Provider Enumeration Date | 06/29/2020 |
Last Update Date | 06/29/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811514508 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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Gouverneur Dental Associates, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 354 E Main St, Gouverneur, NY 13642 Phone: 315-287-4000 Fax: 315-287-4109 |