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General NPI Number Information
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NPI Number | 1770533531
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Entity Type | Organization
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Legal Business Name | NICHOLAS H. PSIMOS, DDS, PLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 1101 N BROADWAY
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City | ROCHESTER
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State | MN
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Zip | 55906-6841
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Country | US
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Telephone | 507-288-0126
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Fax | 507-529-0810
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Provider Business Mailing Address
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Address Line | 1101 N BROADWAY
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City | ROCHESTER
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State | MN
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Zip | 55906-6841
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Country | US
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Telephone | 507-288-0126
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Fax | 507-529-0810
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS H. PSIMOS
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Credential | D.D.S.
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Telephone | 507-288-0126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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