Individual
NIKESHA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
200 PORTLAND ST, COLUMBIA, MO 65201-6525
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(844) 853-8937
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2024016719
MO
Other
Enumeration date
06/06/2022
Last updated
07/19/2024
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