Provider Demographics
NPI:1912461294
Name:KOLAR, NICHOLAS (DDS, MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:KOLAR
Suffix:
Gender:
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 1:340 W LOGAN ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1432
Practice Address - Country:US
Practice Address - Phone:317-776-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014281A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery