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Organization
NICHOLS DENTAL CENTER
Active
Organization
NICHOLS DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY L NICHOLS D.M.D (DOCTOR)
(270) 259-4008
Entity
Organization
Contact information
Practice address
2471 ELIZABETHTOWN RD, LEITCHFIELD, KY 42754-9119
(270) 259-4008
(270) 259-4009
Mailing address
2471 ELIZABETHTOWN RD, LEITCHFIELD, KY 42754-9119
(270) 259-4008
(270) 259-4009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6679
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60066792
—
KY
Enumeration date
02/21/2008
Last updated
02/21/2008
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