Individual
KENT N NICKLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
633 W BAGLEY RD, BEREA, OH 44017-1356
(440) 234-4646
(440) 234-1868
Mailing address
633 W BAGLEY RD, BEREA, OH 44017-1356
(440) 234-4646
(440) 234-1868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.018994
OH
Other
Enumeration date
07/28/2006
Last updated
10/30/2014
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