Individual
LOGAN JENNINGS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2115 ROCKY DR, PARIS, KY 40361-1370
(859) 987-3290
Mailing address
2115 ROCKY DR, PARIS, KY 40361-1370
(859) 987-3290
(859) 987-6800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11612
TN
1223G0001X
General Practice Dentistry
Primary
10816
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2021
Last updated
07/11/2022
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