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Organization

DR RICHARD NICHOLS ORTHODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIRANDA VAN DYKEN CDA (OFFICE COORDINATOR)
(406) 586-8727
Entity
Organization

Contact information

Practice address
208 N 11TH AVE, BOZEMAN, MT 59715
(406) 586-8727
(406) 586-9382
Mailing address
208 N 11TH AVE, BOZEMAN, MT 59715
(406) 586-8727
(406) 586-9382

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1304
MT

Other

Enumeration date
09/28/2007
Last updated
09/28/2007
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