Provider Demographics
NPI:1912461294
Name:KOLAR, NICHOLAS (DDS, MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:KOLAR
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 N WINDOMERE AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-3504
Mailing Address - Country:US
Mailing Address - Phone:260-413-6153
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD # CS3.104
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-645-3979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program