Nick, Thomas John

Nick, Thomas John is an individual health care provider with primary practice located at 630 1St St , Wausau WI 54403-4851. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Nick, Thomas John can be contacted via phone (715) 842-0314.

Contact Information

Primary practice address
630 1St St Wausau WI 54403-4851
Phone: (715) 842-0314
Fax: (715) 842-5565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 811G Wisconsin

Profile Details

NPI number 1912903303
LBN Legal business name Nick, Thomas John
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jul 8th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912903303 NPPES
Wisconsin MEDICAID 33543300

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