Individual
NISHA JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001
(507) 594-6500
Mailing address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 594-6500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14320
MN
122300000X
Dentist
DS041124
PA
Other
Enumeration date
01/05/2017
Last updated
10/30/2019
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