Individual
DR. THOMAS JOHN NICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
630 1ST ST, WAUSAU, WI 54403-4851
(715) 842-0314
(715) 842-5565
Mailing address
630 1ST ST, WAUSAU, WI 54403-4851
(715) 842-0314
(715) 842-5565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
811G
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33543300
—
WI
Enumeration date
06/22/2005
Last updated
07/08/2007
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