Healthy Smiles Nwi

NPI 1003172008 - Dentist - 1223G0001X

NPI Details
NPI 1003172008
Enumeration Date 04/04/2012
Last Updated 01/29/2013
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name NICHOLAS BERNARD NICHOLAS
Position CEO
Phone (219) 938-2637
Fax (219) 938-6338
Practice Location
4629 MELTON RD.
GARY IN, 46403, US
Phone (219) 938-2637
Fax (219) 938-6338
Business Location
4629 MELTON RD.
GARY IN, 46403, US
Phone (219) 938-2637
Fax (219) 938-6338
Toxanomy
Taxonomy Code 1223G0001X
License State Indiana
License Number 12011235A
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According to our database, Healthy Smiles Nwi NPI is 1003172008, taxonomy code is 1223G0001X and license number is 12011235A, license state is located at Indiana. Healthy Smiles Nwi physically located at 4629 Melton Rd., Gary IN, 46403. NPI Number 1033115704 has the healthcare provider type.

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1003172008 NPI number is provided on an as is basis without warranty of any kind. 1003172008 is maintained by the National Plan & Provider Enumeration System. The contents of Healthy Smiles Nwi are for informational purposes only.