Individual
DR. MICHELLE T. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 772-4783
Mailing address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 772-4783
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7780
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60001898
—
KY
Enumeration date
06/29/2006
Last updated
04/04/2014
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