# GLORIA NICHOLS DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Penfield Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568058188
- **Authorized official:** DR. GLORIA NICHOLS DDS (OWNER)
- **Authorized official phone:** (585) 280-0457

## Contact information

- **Practice address:** 1795 PENFIELD RD, PENFIELD, NY 14526-2103
- **Practice address phone:** (585) 377-5090
- **Mailing address:** 1239 NORTHRUP RD, PENFIELD, NY 14526-9601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/17/2020
- **Last updated:** 12/17/2020