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Organization
LES E. NICHOLSON D.D.S. INC.
Active
Organization
LES E. NICHOLSON D.D.S. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LES EDWARD NICHOLSON D.D.S. (PRESIDENT)
(304) 329-1691
Entity
Organization
Contact information
Practice address
112 E COURT ST, KINGWOOD, WV 26537-1437
(304) 329-1691
(304) 329-3382
Mailing address
PO BOX 486, KINGWOOD, WV 26537-0486
(304) 329-1691
(304) 329-3382
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2331
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136227001
—
WV
01
—
42673
UNITED CONCORDIA CORP #
WV
Enumeration date
07/06/2006
Last updated
08/22/2020
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