Gindorff, Nicol Lisa

Gindorff, Nicol Lisa is an individual health care provider with primary practice located at 525 W Cherry St , North Liberty IA 52317-9797. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is her primary health care specialty. Gindorff, Nicol Lisa can be contacted via phone (319) 621-1507.

Contact Information

Primary practice address
525 W Cherry St North Liberty IA 52317-9797
Phone: (319) 621-1507
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D12134 Minnesota
Dental Providers / Dentist 122300000X 08884 Iowa

Profile Details

NPI number 1811059355
LBN Legal business name Gindorff, Nicol Lisa
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Dec 30th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811059355 NPPES
Minnesota MEDICAID 163445300

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