# NICOLAS S. VEACO, M.D., D.D.S., A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982843033
- **Authorized official:** DR. NICOLAS S VEACO M.D., D.D.S. (SOLE OWNER/PRESIDENT)
- **Authorized official phone:** (209) 951-9045

## Contact information

- **Practice address:** 3427 DEER PARK DR, STE B, STOCKTON, CA 95219-2355
- **Practice address phone:** (209) 951-9045
- **Practice address fax:** (209) 951-9047
- **Mailing address:** 3427 DEER PARK DR, STE B, STOCKTON, CA 95219-2355
- **Mailing address phone:** (209) 951-9045
- **Mailing address fax:** (209) 951-9047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 00G678190 | CA | Yes |

## Other

- **Enumeration date:** 02/12/2009
- **Last updated:** 06/21/2018