Individual
JOEL JUSTIN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.H.A.
Contact information
Practice address
11132 W CALIFORNIA AVENUE, YOUNGTOWN, AZ 85363-1201
(623) 565-2446
Mailing address
11132 W CALIFORNIA AVENUE, YOUNGTOWN, AZ 85363-1201
(623) 565-2446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6673
AZ
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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