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Organization
EPIFANIA V NICOLAS DDS INC.
Active
Organization
EPIFANIA V NICOLAS DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EPIFANIA VIOLA NICOLAS (PRESIDENT/OWNER)
(714) 906-9116
Entity
Organization
Contact information
Practice address
301 E HOBSONWAY, BLYTHE, CA 92225-1732
(760) 922-2300
(760) 922-2277
Mailing address
1637 S EUCLID ST, ANAHEIM, CA 92802-2406
(714) 906-9116
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B4029004
—
CA
Enumeration date
02/11/2016
Last updated
04/06/2016
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