Organization
BRENT O NICHOLS DDS APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT O NICHOLS DDS (OWNER, DENTIST)
(714) 724-9072
Entity
Organization
Contact information
Practice address
18800 DELAWARE ST STE 600, HUNTINGTON BEACH, CA 92648-6017
(714) 960-2600
(714) 960-2699
Mailing address
18800 DELAWARE ST STE 600, HUNTINGTON BEACH, CA 92648-6017
(714) 724-9072
(714) 960-2699
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46509
DENTAL
CA
Enumeration date
04/26/2022
Last updated
04/26/2022
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