Individual
DR. STEPHEN MARK NIKODEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
330 PROGRESS CIR STE C, BLUE RIDGE, GA 30513-6262
(678) 365-0322
Mailing address
134 FRONTENAC FRST, SAINT LOUIS, MO 63131-3220
(314) 402-1168
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2023021406
MO
1223G0001X
General Practice Dentistry
Primary
DN123946
GA
Other
Enumeration date
03/31/2023
Last updated
10/13/2025
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