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Individual

EDWARD LEE NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
720 E LATHAM AVE, SUITE 2, HEMET, CA 92543-4371
(951) 929-4800
(951) 929-1591
Mailing address
720 E LATHAM AVE, SUITE 2, HEMET, CA 92543-4371
(951) 929-4800
(951) 929-1591

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
35960
CA

Other

Enumeration date
03/20/2007
Last updated
07/08/2007
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