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Organization
NICHOLSON FAMILY DENTAL LLC
Active
Organization
NICHOLSON FAMILY DENTAL LLC
Active
Other names
Small Smiles Dental Center of Muncie LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA ANN NICHOLSON DDS (OWNER/DENTIST)
(260) 824-2811
Entity
Organization
Contact information
Practice address
116 E DUSTMAN RD, STE A, BLUFFTON, IN 46714
(260) 824-7195
(260) 824-2812
Mailing address
116 E DUSTMAN RD, STE A, BLUFFTON, IN 46714
(260) 824-7195
(260) 824-2812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201004460
—
IN
Enumeration date
10/19/2010
Last updated
05/14/2021
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