| Nickolas A. Kephart Dds Pllc | |
|
3165 Maplewood Ave Winston Salem NC 27103-3919 | |
| (336) 760-9840 | |
| (336) 760-9841 |
| Full Name | Nickolas A. Kephart Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3165 Maplewood Ave, Winston Salem, North Carolina |
| Authorized Official Name and Position | Nickolas Andrew Kephart (OWNER) |
| Authorized Official Contact | 3367609840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nickolas A. Kephart Dds Pllc 3165 Maplewood Ave Winston Salem NC 27103-3919 Ph: (336) 760-9840 | Nickolas A. Kephart Dds Pllc 3165 Maplewood Ave Winston Salem NC 27103-3919 Ph: (336) 760-9840 |
| NPI Number | 1225684079 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 08/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225684079 | NPI | - | NPPES |
| 1154559318 | Other | VA | NPI |
| 1427494350 | Other | NC | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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