Individual
DR. NICHOLAS BERNARD CAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3099 CENTRAL AVE, LAKE STATION, IN 46405-2207
(219) 763-8112
(219) 764-3251
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-3251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011235A
IN
1223G0001X
General Practice Dentistry
DS8318
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
09/13/2006
Last updated
08/18/2010
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