| NPI | 1184364036 |
|---|---|
| Doing Business As | LINCOLN TRAIL DENTAL, PLLC |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER GLENN NICHOLS Owner 270-505-5066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-03-30 |