Individual
DR. JONATHAN ROBERT NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6643 U S HIGHWAY 98, HATTIESBURG, MS 39402-8442
(601) 450-6060
(601) 450-6062
Mailing address
6643 HIGHWAY 98, HATTIESBURG, MS 39402
(601) 450-6060
(601) 450-6062
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3761-14
MS
Other
Enumeration date
05/14/2014
Last updated
09/01/2016
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