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Individual

DR. TINA H NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
13600 DAVID O. DODD, LITTLE ROCK, AR 72210
(501) 312-7576
(501) 687-0669
Mailing address
13600 DAVID O. DODD, LITTLE ROCK, AR 72210
(501) 312-7576
(501) 687-0669

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3311
AR
1223G0001X
General Practice Dentistry
3435
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181376608
AR
Enumeration date
07/15/2006
Last updated
04/25/2013
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