Individual
DR. JANICE BREAUX NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
40 25TH ST NW, CLEVELAND, TN 37311-3829
(423) 476-4418
(423) 476-0189
Mailing address
40 25TH ST NW, CLEVELAND, TN 37311-3829
(423) 476-4418
(423) 476-0189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS004235
TN
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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