MEDICARE: DR. NICHOLAS JAMES MOLNAR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30.026497	OH

General Provider Information

NPI Number	:	1619549631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS JAMES MOLNAR DDS

Provider Business Mailing Address
First Line	:	1705 S HOME RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44904-8633
Country	:	US
Telephone Number	:	419-543-1835
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 FOREST DR STE A
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-8215
Country	:	US
Telephone Number	:	614-939-0400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	07/12/2021

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