Provider Demographics
NPI:1669676698
Name:NICHOLS, HOWARD C (DENTIST DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:C
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:DENTIST DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:165 MAIN ST
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001
Mailing Address - Country:US
Mailing Address - Phone:716-542-2521
Mailing Address - Fax:716-542-2521
Practice Address - Street 1:165 MAIN ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001
Practice Address - Country:US
Practice Address - Phone:716-542-2521
Practice Address - Fax:716-542-2521
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice