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Individual

NICHOLAS GUAJARDO BOHLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4TH AND INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310
(719) 526-5537
Mailing address
4TH AND INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
05/15/2020
Last updated
05/15/2020
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