Individual
ANDREW NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
925 W 34TH ST, LOS ANGELES, CA 90089-0058
(213) 740-2805
Mailing address
17 BEACON BAY, NEWPORT BEACH, CA 92660-7222
(949) 500-7547
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
103534
CA
Other
Enumeration date
05/18/2017
Last updated
06/25/2019
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