Individual
MR. MICHAEL W NICHOLS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
116 CUMBERLAND LN, JACKSBORO, TN 37757-2737
(423) 562-9459
(423) 566-7195
Mailing address
116 CUMBERLAND LN, JACKSBORO, TN 37757-2737
(423) 562-9459
(423) 566-7195
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2899
TN
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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