Provider Demographics
NPI:1902094527
Name:NICHOLS, RICHARD E (DDS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 PARK COUNTY ROAD 43
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421
Mailing Address - Country:US
Mailing Address - Phone:303-838-0311
Mailing Address - Fax:303-816-0181
Practice Address - Street 1:460 PARK COUNTY ROAD 43
Practice Address - Street 2:CROW HILL FAMILY DENTAL
Practice Address - City:BAILEY
Practice Address - State:CO
Practice Address - Zip Code:80421
Practice Address - Country:US
Practice Address - Phone:303-838-0311
Practice Address - Fax:303-816-0181
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6668122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist