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Organization
DR. HOLLY J. NICHOLS, DMD, PC
Active
Organization
DR. HOLLY J. NICHOLS, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY J NICHOLS DMD (PRESIDENT)
(541) 296-9415
Entity
Organization
Contact information
Practice address
308 E 4TH ST, THE DALLES, OR 97058-2208
(541) 296-9415
(541) 296-8846
Mailing address
308 E 4TH ST, THE DALLES, OR 97058-2208
(541) 296-9415
(541) 296-8846
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D7013
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568539617
NPI
OR
Enumeration date
08/26/2015
Last updated
08/26/2015
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