Provider Demographics
NPI:1447520895
Name:ENGLAND, NICK ARNOLD JR (DMD)
Entity type:Individual
Prefix:DR
First Name:NICK
Middle Name:ARNOLD
Last Name:ENGLAND
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4123
Mailing Address - Country:US
Mailing Address - Phone:606-237-4750
Mailing Address - Fax:
Practice Address - Street 1:534 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4123
Practice Address - Country:US
Practice Address - Phone:606-237-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60047040Medicaid