Individual
DR. CAROL NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
019030615
IL
1223P0221X
Pediatric Dentistry
Primary
10656
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2014
Last updated
07/31/2018
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