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Organization
NICOLAS DENTAL CORPORATION
Active
Organization
NICOLAS DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EPIFANIA VIOLA NICOLAS DDS (PRESIDENT/OWNER)
(714) 906-9116
Entity
Organization
Contact information
Practice address
8003 ALICANTE AVE, LAMONT, CA 93241-1712
(714) 906-9116
Mailing address
8003 ALICANTE AVE, LAMONT, CA 93241-1712
(714) 906-9116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B4029004
—
CA
Enumeration date
12/17/2015
Last updated
04/05/2016
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