| Nichols Periodontics Llc | |
|
2401 5th Street North Suite 2 Columbus MS 39705 | |
| (662) 713-1111 | |
| (662) 713-1113 |
| Full Name | Nichols Periodontics Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2401 5th Street North, Columbus, Mississippi |
| Authorized Official Name and Position | Jeffrey Todd Nichols (OWNER) |
| Authorized Official Contact | 6627131111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nichols Periodontics Llc 2401 5th Street North Suite 2 Columbus MS 39705 Ph: (662) 713-1111 | Nichols Periodontics Llc 2401 5th Street North Suite 2 Columbus MS 39705 Ph: (662) 713-1111 |
| NPI Number | 1134341407 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134341407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 2882-95 (Mississippi) | Primary |
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