Individual provider · Type 1 NPI

Keith Nicholson, D.D.S

Orthodontics and Dentofacial Orthopedics Dentistry · Philadelphia, PA

NPI number 1093959660 Active

Practice location

100 S Broad St Ste 1530
Philadelphia, PA 19110-1026

Call (267) 691-0606 Map

Mailing address

University Of Louisville, 501 South Preston St.
Louisville, KY 40292-0001

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X8795/879 (KY)
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X8644 (NC)
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X12012234A (IN)
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400XDS043962 (PA)
Dentist 122300000X8644 (NC)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1093959660

Keith Nicholson, D.D.S's National Provider Identifier is 1093959660, issued on Apr 27, 2009. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Philadelphia, PA. The record was last updated on May 28, 2023.