Organization
LES E. NICHOLSON D.D.S. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LES EDWARD NICHOLSON D.D.S. (PRESIDENT)
(304) 594-1499
Entity
Organization
Contact information
Practice address
2220 CHEAT RD, MORGANTOWN, WV 26508-4453
(304) 594-1499
(304) 594-0150
Mailing address
2220 CHEAT RD, MORGANTOWN, WV 26508-4453
(304) 594-1499
(304) 594-0150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2331
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136227001
—
WV
01
—
98787
UNITED CONCORDIA CORP #
WV
Enumeration date
06/20/2006
Last updated
08/22/2020
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