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Individual

DR. LUCAS JAMES NICHOLAOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 825-5619
Mailing address
1441 S BEVERLY GLEN BLVD APT 112, LOS ANGELES, CA 90024-6139

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
106982
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NA
CA
Enumeration date
02/01/2021
Last updated
11/17/2021
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