Individual
DR. NICKOLAS STANLEY MASKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4720 LAKE STREET, LAKE CHARLES, LA 70605
(337) 888-4771
(337) 888-4772
Mailing address
4720 LAKE STREET, LAKE CHARLES, LA 70605
(337) 888-4771
(337) 888-4772
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1190
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6365
LA
Other
Enumeration date
06/27/2013
Last updated
12/20/2019
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