Jacy Adam Nicholson, D.D.S.

NPI #1306282918 in Vincennes, Indiana

Provider Information

NPI Number: 1306282918
Entity Type: Individual
Name: Jacy Adam Nicholson, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: May 22, 2013
Last Updated: May 22, 2013

Practice Location

Address: 630 KIMMELL RD
Address 2: SUITE C
City: Vincennes
State: Indiana
ZIP Code: 47591-6330
Phone: (812) 316-2013

Specialties & Taxonomy Codes

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

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