Organization
TINA NICHOLS DDS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY SCRUGGS (OFFICE MANAGER)
(501) 664-7444
Entity
Organization
Contact information
Practice address
619 BEECHWOOD ST, LITTLE ROCK, AR 72205-3846
(150) 166-4744
(501) 232-9053
Mailing address
619 BEECHWOOD ST, LITTLE ROCK, AR 72205-3846
(150) 166-4744
(501) 232-9053
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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