Healthcare Provider Details

I. General information

NPI: 1831260173
Provider Name (Legal Business Name): NICHOLAS J VOLZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MULBERRY STREET
EVANSVILLE IN
47713-1252
US

IV. Provider business mailing address

315 MULBERRY STREET
EVANSVILLE IN
47713-1252
US

V. Phone/Fax

Practice location:
  • Phone: 812-421-7489
  • Fax: 812-436-0209
Mailing address:
  • Phone: 812-421-7489
  • Fax: 812-436-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12008829A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: