Provider Demographics
NPI:1750545216
Name:VERNICE, NICHOLAS (DDS, FAGD, PC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:VERNICE
Suffix:
Gender:M
Credentials:DDS, FAGD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2308
Mailing Address - Country:US
Mailing Address - Phone:516-775-1218
Mailing Address - Fax:516-775-1218
Practice Address - Street 1:166 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2308
Practice Address - Country:US
Practice Address - Phone:516-775-1218
Practice Address - Fax:516-775-1218
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041648122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist