DR. Jon D Nickelsen, DDS

NPI #1124172465 in Elgin, Illinois

Provider Information

NPI Number: 1124172465
Entity Type: Individual
Name: DR. Jon D Nickelsen, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jan 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 523 N MCLEAN BLVD
City: Elgin
State: Illinois
ZIP Code: 60123-3269
Phone: (847) 742-8811

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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