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Contact Information

TIMOTHY R NICKLAS, DDS
HWY 56 & 270 JUNCTION
WEWOKA, OK74884
 Phone: 405-257-7318
 Fax: 405-257-2696
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for TIMOTHY R NICKLAS · (Male)

NPI # 1396744280
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/21/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK License # 1000
  • OK Medicaid 1304881
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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