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General NPI Number Information
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NPI Number | 1346732013
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Entity Type | Individual
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Provider Name | LAUREN NICHOLS DDS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 7707 E 111TH ST STE 105
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-299-7750
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Fax |
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Provider Business Mailing Address
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Address Line | 7714 S KINGSTON AVE
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City | TULSA
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State | OK
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Zip | 74136-8509
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Country | US
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Telephone | 918-520-5309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7062
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License Number State | OK
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