Individual
MR. NICHOLAS ALLEN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
170 WAMPLERS LAKE RD, BROOKLYN, MI 49230-9585
(517) 592-3003
(517) 592-5787
Mailing address
170 WAMPLERS LAKE RD, BROOKLYN, MI 49230-9585
(517) 592-3003
(517) 592-5785
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901022639
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801389499
—
MI
Enumeration date
06/08/2018
Last updated
09/10/2024
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