Individual
DR. NATHAN COOPER NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
112 E CENTRAL AVE, ARKANSAS CITY, KS 67005-2602
(620) 442-2575
(620) 442-2570
Mailing address
112 E CENTRAL AVE, ARKANSAS CITY, KS 67005-2602
(620) 442-2575
(620) 442-2570
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60023
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100365030A
—
KS
01
—
1004953
DORAL PROVIDER #
KS
01
—
116545
BLUE CROSS BLUE SHIELD
KS
01
—
60023
DELTA DENTAL PROVIDER #
KS
Enumeration date
10/25/2005
Last updated
06/20/2012
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