Provider Demographics
NPI:1588667141
Name:CAUWELS, NICHOLE MICHELLE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:MICHELLE
Last Name:CAUWELS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:MICHELLE
Other - Last Name:POOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6100 W 41ST STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106
Mailing Address - Country:US
Mailing Address - Phone:605-361-1900
Mailing Address - Fax:605-361-3599
Practice Address - Street 1:6100 W 41ST STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106
Practice Address - Country:US
Practice Address - Phone:605-361-1900
Practice Address - Fax:605-361-3599
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM 9581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice