Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DEN1001900 | DC |
NPI | 1518488014 |
---|---|
Provider Name | Dr. David Scott Nichols |
First Address | Rockville, MD 20850-6676 |
Second Address | Washington, DC 20016-4119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2017 |
Last Update Date | 05/10/2021 |