Individual
DR. MATTHEW NICHOLSON DAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1830 DESTINY LN, SUITE 119, BOWLING GREEN, KY 42104-1087
(270) 393-9925
(270) 393-9928
Mailing address
1830 DESTINY LN, SUITE 119, BOWLING GREEN, KY 42104-1087
(270) 393-9925
(270) 393-9928
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9573
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2013
Last updated
11/10/2015
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