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Organization
NICHOLAS POBLETE, D.D.S., INC.
Active
Organization
NICHOLAS POBLETE, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS ELLIS POBLETE D.D.S. (DENTIST)
(209) 521-6822
Entity
Organization
Contact information
Practice address
1316 COFFEE RD, BLDG. C, MODESTO, CA 95355-3191
(209) 521-6822
(209) 521-0466
Mailing address
1316 COFFEE RD, BLDG. C, MODESTO, CA 95355-3191
(209) 521-6822
(209) 521-0466
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49190
CA
Other
Enumeration date
05/30/2007
Last updated
09/07/2011
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