Individual
FELICIA NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
57 E ECKERSON RD, SPRING VALLEY, NY 10977-3014
(845) 426-2569
Mailing address
16 ALEXANDER AVE, SPRING VALLEY, NY 10977-2343
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061020-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2018
Last updated
12/21/2020
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