Organization
JGN INVESTMENTS LLC
Active
Other names
Jeffrey G Nichols DMD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY GLEN NICHOLS DMD (PRESIDENT)
(321) 255-0199
Entity
Organization
Contact information
Practice address
336 N BABCOCK ST STE 102, MELBOURNE, FL 32935-7325
(321) 255-0199
(321) 255-7920
Mailing address
336 N BABCOCK ST STE 102, MELBOURNE, FL 32935-7325
(321) 255-0199
(321) 751-8668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15903
FL
Other
Enumeration date
11/13/2007
Last updated
10/17/2008
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