| J. Wade Nichols Dmd, Pa | |
|
4605 Oleander Dr Myrtle Beach SC 29577-5739 | |
| (843) 554-5300 | |
| (843) 554-1067 |
| Full Name | J. Wade Nichols Dmd, Pa |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 4605 Oleander Dr, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Sharon Dibenedetto (INS. COORD.) |
| Authorized Official Contact | 8435545300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Wade Nichols Dmd, Pa 4605 Oleander Dr Myrtle Beach SC 29577-5739 Ph: (843) 554-5300 | J. Wade Nichols Dmd, Pa 4605 Oleander Dr Myrtle Beach SC 29577-5739 Ph: (843) 554-5300 |
| NPI Number | 1851516884 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851516884 | NPI | - | NPPES |
| SC19560 | Medicaid | SC | |
| ZA9681 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | SC1956 (South Carolina) | Primary |
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