Provider Demographics
NPI:1497426183
Name:ROMANS, NICHOLAS ROBERT (DMD, MSD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ROBERT
Last Name:ROMANS
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 CHIEF JUSTICE CUSHING HWY STE LL1
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1391
Mailing Address - Country:US
Mailing Address - Phone:620-205-9494
Mailing Address - Fax:
Practice Address - Street 1:223 CHIEF JUSTICE CUSHING HWY STE LL1
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1391
Practice Address - Country:US
Practice Address - Phone:781-236-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859192122300000X, 1223X0400X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics