Organization
NICOLE M JANE, DDS, MS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE MARIE JANE DDS, MS (ORTHODONTIST/PRESIDENT)
(530) 541-6585
Entity
Organization
Contact information
Practice address
965 TAHOE KEYS BLVD, SOUTH LAKE TAHOE, CA 96150-7161
(530) 541-6585
Mailing address
965 TAHOE KEYS BLVD, SOUTH LAKE TAHOE, CA 96150-7161
(530) 541-6585
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
53320
CA
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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