Individual
DR. NICHOLAS R JIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12778 RANCHO PENASQUITOS BLVD, SUITE A, SAN DIEGO, CA 92129-2946
(858) 780-9794
(858) 780-9690
Mailing address
12778 RANCHO PENASQUITOS BLVD, SUITE A, SAN DIEGO, CA 92129-2946
(858) 780-9794
(858) 780-9690
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
62328
CA
1223P0221X
Pediatric Dentistry
Primary
62328
CA
Other
Enumeration date
06/15/2011
Last updated
10/24/2013
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