Individual
DR. WILLIAM R NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
751 TRINITY DR STE 305, LOS ALAMOS, NM 87544-3357
(505) 661-9060
(505) 738-0338
Mailing address
4701 LOMAS BLVD NE, ALBUQUERQUE, NM 87110
(505) 433-5204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3624
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568883338
—
NM
Enumeration date
03/15/2012
Last updated
05/04/2022
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