Individual
DR. NICHOLAS ALLAN WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1289 N MONROE DR, XENIA, OH 45385-1655
(937) 673-5934
Mailing address
6797 SUN RIDGE WAY, WAYNESVILLE, OH 45068-8369
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30026316
OH
Other
Enumeration date
07/28/2016
Last updated
11/18/2022
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