| Nicholson Family Dental Llc | |
|
116 E Dustman Rd Ste A Bluffton IN 46714 | |
| (260) 824-7195 | |
| (260) 824-2812 |
| Full Name | Nicholson Family Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 116 E Dustman Rd, Bluffton, Indiana |
| Authorized Official Name and Position | Teresa Ann Nicholson (OWNER/DENTIST) |
| Authorized Official Contact | 2608242811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholson Family Dental Llc 116 E Dustman Rd Ste A Bluffton IN 46714 Ph: (260) 824-7195 | Nicholson Family Dental Llc 116 E Dustman Rd Ste A Bluffton IN 46714 Ph: (260) 824-7195 |
| NPI Number | 1720398118 |
|---|---|
| Provider Enumeration Date | 10/19/2010 |
| Last Update Date | 05/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720398118 | NPI | - | NPPES |
| 201004460 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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