Organization
NICHOLSON FAMILY DENTAL LLC
Active
Other names
Small Smiles Dental Center of Muncie LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA ANN NICHOLSON DDS (OWNER/DENTIST)
(260) 824-2811
Entity
Organization
Contact information
Practice address
116 E DUSTMAN RD, STE A, BLUFFTON, IN 46714
(260) 824-7195
(260) 824-2812
Mailing address
116 E DUSTMAN RD, STE A, BLUFFTON, IN 46714
(260) 824-7195
(260) 824-2812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201004460
—
IN
Enumeration date
10/19/2010
Last updated
05/14/2021
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