Individual
DR. SAMUEL MCNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6140 TUTT BLVD STE 150, COLORADO SPRINGS, CO 80923-3574
(719) 622-9200
Mailing address
6140 TUTT BLVD STE 150, COLORADO SPRINGS, CO 80923-3574
(719) 622-9200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00202859
CO
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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