Individual
NICHOLAS STEPHEN ECONOMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1233 63RD ST, DES MOINES, IA 50311-1943
(515) 277-6358
Mailing address
1233 63RD ST, DES MOINES, IA 50311-1943
(515) 277-6358
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
09657
IA
1223G0001X
General Practice Dentistry
09657
IA
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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