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Organization
THOMAS A NUCKOLS DDS PA
Active
Organization
THOMAS A NUCKOLS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS ARTHUR NUCKOLS DDS (PRESIDENT)
(785) 434-4565
Entity
Organization
Contact information
Practice address
310 SW FIRST, PLAINVILLE, KS 67663-0057
(785) 434-4565
(785) 688-4105
Mailing address
310 SW FIRST, PO BOX 57, PLAINVILLE, KS 67663-0057
(785) 434-4565
(785) 688-4105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5689
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116846
BLUE CROSS BLUE SHIELD
KS
Enumeration date
03/23/2006
Last updated
01/10/2013
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