Provider Demographics
NPI:1952615015
Name:NICHOLSON, MILTON E (DDS)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:E
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PENN CENTER BLVD
Mailing Address - Street 2:#210
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5511
Mailing Address - Country:US
Mailing Address - Phone:412-825-0200
Mailing Address - Fax:412-825-4627
Practice Address - Street 1:300 PENN CENTER BLVD
Practice Address - Street 2:#210
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5511
Practice Address - Country:US
Practice Address - Phone:412-825-0200
Practice Address - Fax:412-825-4627
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS013831L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist