Terry E Nichols Dmd PA

NPI #1326223843 in Graceville, Florida

Provider Information

NPI Number: 1326223843
Entity Type: Organization
Organization Name: Terry E Nichols Dmd PA
Primary Specialty: Dentist
Enumeration Date: Jan 3, 2008
Last Updated: Jan 3, 2008

Practice Location

Address: 966 7TH AVE
City: Graceville
State: Florida
ZIP Code: 32440-2224
Phone: (850) 263-6400

Authorized Official

Name: DR. TERRY EMMETT NICHOLS, DMD PA
Title: OWNER
Phone: (850) 263-6400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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