Individual
DR. NICHOLAS JON BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-022925
OH
1223G0001X
General Practice Dentistry
2901019776
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2872986
—
OH
Enumeration date
05/30/2008
Last updated
05/06/2010
Update your record
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