Individual
DR. DANA M NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
203 E LAKE AVE, NEW CARLISLE, OH 45344-1465
(937) 845-9422
Mailing address
203 E LAKE AVE, PO BOX 66, NEW CARLISLE, OH 45344-1465
(937) 845-9422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21982
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2504267
—
OH
Enumeration date
10/19/2007
Last updated
10/19/2007
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