Individual
DR. NICKOLAS ANDREW KEPHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3165 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-3962
(336) 760-9840
Mailing address
3165 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-3962
(336) 760-9840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9494
NC
Other
Enumeration date
05/19/2013
Last updated
11/22/2013
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