Individual
JAY L NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2471 ELIZABETHTOWN RD, LEITCHFIELD, KY 42754-9119
(270) 259-4008
(270) 259-4009
Mailing address
2471 ELIZABETHTOWN RD, LEITCHFIELD, KY 42754-9119
(270) 259-4008
(270) 259-4009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
KY6679
KY
Other
Enumeration date
11/22/2005
Last updated
07/08/2007
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