Basic Information
| Provider Information | |||||||||
| NPI: | 1427113976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NICHOLS | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 263 FARMINGTON AVE # MC-3905 | ||||||||
| Address2: | UCONN SCHOOL OF DENTAL MEDICINE | ||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060303905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606792207 | ||||||||
| FaxNumber: | 8606791899 | ||||||||
| Practice Location | |||||||||
| Address1: | 263 FARMINGTON AVE # MC-3905 | ||||||||
| Address2: | UCONN SCHOOL OF DENTAL MEDICINE | ||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060300001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606792364 | ||||||||
| FaxNumber: | 8606797507 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2006 | ||||||||
| LastUpdateDate: | 11/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0300X | 006982 | CT | Y | Dental Providers | Dentist | Periodontics |
No ID Information.