Dr. Jerry Dallas Nichols, D.D.S.
Dentist, General Practice in Pearcy, AR. Individual provider (NPI-1).
NPI number1285642876
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1285642876
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jerry Dallas Nichols
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 1907 | AR | Yes |
Practice location
3354 Old Airport RdPearcy, AR 71964-9445
Phone 501-767-0011 · Fax 501-767-5686
Mailing address
3354 Old Airport RdPearcy, AR 71964-9445
Phone 501-767-0011 · Fax 501-767-5686
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