Provider Demographics
NPI:1437274545
Name:NICHOLAS, STEVEN B (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2A MALL RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1821
Mailing Address - Country:US
Mailing Address - Phone:304-733-5500
Mailing Address - Fax:
Practice Address - Street 1:2A MALL RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1821
Practice Address - Country:US
Practice Address - Phone:304-733-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2802122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist