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Russell Dewitt Nichols, DMD
General Practice Dentistry in Enterprise, Alabama
NPI 1780623843

Russell Dewitt Nichols is a General Practice Dentistry based in Enterprise, AL and is specialized in General Practice. Russell Dewitt Nichols practices in Enterprise, AL and has the professional credentials of DMD. The NPI Number for Russell Dewitt Nichols is 1780623843 and holds a License No. 4810A1 (Alabama).

The current practice location address for Russell Dewitt Nichols is 812 Boll Weevil Cir, Enterprise, AL and can be reached out via phone at 334-347-9283 and via fax at 334-347-7664. You can also correspond with Russell Dewitt Nichols through the mailing address at 108 E KINGSWOOD DR, ENTERPRISE, AL - 36330-4119 (mailing address contact number: 334-347-9283).

Location: 812 Boll Weevil Cir, Enterprise, AL, 36330-4119
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780623843
Provider Name
Russell Dewitt Nichols
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
812 Boll Weevil Cir, Enterprise, AL, 36330-4119
Phone Number
334-347-9283
Fax Number
334-347-7664
Provider Enumeration Date
06/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
51027316 01 AL BLUE CROSS BLUE SHIELD
487225 01 AL UNITED CONCORDIA
4810 01 AL DELTA
institution
Provider Business Practice Location Address Details
Address
812 Boll Weevil Cir
City
Enterprise
State
Alabama
Zip
36330-2079
Phone Number
334-347-9283
Fax Number
334-347-7664
person
Provider Business Mailing Address Details
Address
108 E Kingswood Dr
City
Enterprise
State
Alabama
Zip
36330-4119
Phone Number
334-347-9283
Fax Number
334-347-7664
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
4810A1 (Alabama)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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