Individual
DR. SCOTT KEVIN NICHOLSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
715 ELM ST SW, ALBANY, OR 97321-1935
(541) 928-6650
(541) 928-6650
Mailing address
715 ELM ST SW, ALBANY, OR 97321-1935
(541) 928-6650
(541) 812-0150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6096
OR
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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