# NICHOLAS COSMETIC DENTAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992088785
- **Authorized official:** SHIREEN MALIK (DENTIST)
- **Authorized official phone:** (917) 239-9313

## Contact information

- **Practice address:** 1128 WALNUT STREET, 5TH FLOOR, PHILADELPHIA, PA 19107
- **Practice address phone:** (646) 241-6384
- **Mailing address:** 1128 WALNUT STREET, 5TH FLOOR, PHILADELPHIA, PA 19107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS038604 | PA | Yes |

## Other

- **Enumeration date:** 09/28/2011
- **Last updated:** 09/28/2011