Individual
JEFFREY NICHELINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3419 BROADWAY ST, STE-H1, AMERICAN CANYON, CA 94503-1261
(707) 651-9244
(707) 651-9278
Mailing address
3419 BROADWAY ST, STE-H1, AMERICAN CANYON, CA 94503-1261
(707) 651-9244
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
60422
CA
Other
Enumeration date
09/10/2012
Last updated
01/30/2014
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