Individual
DR. MARK ROBERTS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3651 HIGHWAY 59 N, GROVE, OK 74344-3705
(918) 786-4084
(918) 786-4984
Mailing address
3651 HIGHWAY 59 N, GROVE, OK 74344-3705
(918) 786-4084
(918) 786-4984
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4424
OK
Other
Enumeration date
06/21/2006
Last updated
07/08/2007
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