Individual
JAMES A NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
120 SOUTH 28TH AVENUE, HATTIESBURG, MS 39401
(601) 268-1111
Mailing address
120 SOUTH 28TH AVENUE, HATTIESBURG, MS 39401
(601) 268-1111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
194181
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6883
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060351
—
MS
Enumeration date
04/02/2008
Last updated
04/03/2008
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