Individual
DR. KRISTEN BENAE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, JBSA LACKLAND, TX 78236-9908
(210) 292-0768
Mailing address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, JBSA LACKLAND, TX 78236-9908
(210) 292-0768
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
6544
NE
Other
Enumeration date
01/13/2006
Last updated
07/17/2023
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