Individual
DR. NICHOLAS JOHN FANGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1406 N US HIGHWAY 71, CARROLL, IA 51401-3344
(712) 792-2630
(712) 792-5547
Mailing address
1406 N US HIGHWAY 71, CARROLL, IA 51401-3344
(712) 792-2630
(712) 792-5547
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
07225
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042820
—
IA
Enumeration date
07/06/2006
Last updated
12/09/2013
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