Organization
PHILIP L NICHOLSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP LEE NICHOLSON DDS (PRES)
(317) 831-4240
Entity
Organization
Contact information
Practice address
150 N INDIANA ST, MOORESVILLE, IN 46158-1506
(317) 831-4240
(317) 831-4473
Mailing address
150 N INDIANA ST, MOORESVILLE, IN 46158-1506
(317) 831-4240
(317) 831-4473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007371B
IN
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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