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Organization
TERRY E NICHOLS DMD PA
Active
Organization
TERRY E NICHOLS DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY EMMETT NICHOLS DMD PA (OWNER)
(850) 263-6400
Entity
Organization
Contact information
Practice address
966 7TH AVE, GRACEVILLE, FL 32440-2224
(850) 263-6400
(850) 263-4717
Mailing address
PO BOX 614, GRACEVILLE, FL 32440-0614
(850) 263-6400
(850) 263-4717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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