Individual
DR. IRIS CORINA MCNICHOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1481 WEST 10TH STREET, INDIANAPOLIS, IN 46202
(317) 988-2733
(317) 988-5377
Mailing address
1481 WEST 10TH STREET, INDIANAPOLIS, IN 46202
(317) 988-2733
(317) 988-5377
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009732
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200169270A
—
IN
Enumeration date
09/20/2006
Last updated
01/06/2017
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