Nichols, Russell Dewitt
Nichols, Russell Dewitt is an individual health care provider with primary practice located at 812 Boll Weevil Cir , Enterprise AL 36330-2079. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Nichols, Russell Dewitt can be contacted via phone (334) 347-9283.Contact Information
Primary practice address
812 Boll Weevil Cir
Enterprise AL 36330-2079
Phone: (334) 347-9283
Fax: (334) 347-7664
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4810A1 | Alabama |
Profile Details
| NPI number | 1780623843 |
|---|---|
| LBN Legal business name | Nichols, Russell Dewitt |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Apr 8th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780623843 | NPPES |
| Alabama | Other | 51027316 | BLUE CROSS BLUE SHIELD |
| Alabama | Other | 487225 | BLUE CROSS BLUE SHIELD |
| Alabama | Other | 4810 | BLUE CROSS BLUE SHIELD |
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