Individual
KIMBERLY STEVENS NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1821 DELONG RD, LEXINGTON, KY 40515-9505
(859) 539-1529
Mailing address
1821 DELONG RD, LEXINGTON, KY 40515-9505
(859) 539-1529
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411478
VA
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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