Individual
JOE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 HIGHLAND DR, HOUSTON, MS 38851-2423
(662) 456-3443
Mailing address
100 HIGHLAND DR, HOUSTON, MS 38851-2423
(662) 456-3443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1675-75
MS
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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