Provider Demographics
NPI:1841272184
Name:NICKINS, JOHN LAWS JR (DDS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LAWS
Last Name:NICKINS
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:2 E ROLLING CROSSROADS
Mailing Address - Street 2:SUITE 57
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6211
Mailing Address - Country:US
Mailing Address - Phone:410-747-1830
Mailing Address - Fax:410-747-1823
Practice Address - Street 1:2 E ROLLING CROSSROADS
Practice Address - Street 2:SUITE 57
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6211
Practice Address - Country:US
Practice Address - Phone:410-747-1830
Practice Address - Fax:410-747-1823
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD6054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist