Organization
NICHOLS PERIODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY TODD NICHOLS D.M.D (OWNER)
(662) 713-1111
Entity
Organization
Contact information
Practice address
2401 5TH STREET NORTH, SUITE 2, COLUMBUS, MS 39705
(662) 713-1111
(662) 713-1113
Mailing address
2401 5TH STREET NORTH, SUITE 2, COLUMBUS, MS 39705
(662) 713-1111
(662) 713-1113
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2882-95
MS
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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