Organization
KENT N NICKLAS DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT N NICKLAS DDS (OWNER/DENTIST)
(440) 234-4646
Entity
Organization
Contact information
Practice address
633 W BAGLEY RD, BEREA, OH 44017-1356
(440) 234-4646
(440) 234-1868
Mailing address
633 W BAGLEY RD, BEREA, OH 44017-1356
(440) 234-4646
(440) 234-1868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18994
OH
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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