Individual
JONATHAN KIYOMI NAKANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
390 LOMBARD ST, THOUSAND OAKS, CA 91360-5808
(805) 496-0112
Mailing address
390 LOMBARD ST, THOUSAND OAKS, CA 91360-5808
(805) 496-0112
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
53248
CA
Other
Enumeration date
05/08/2007
Last updated
04/18/2012
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