Individual
NICOLE CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
143 S MASON ST, ARROYO GRANDE, CA 93420-3312
(909) 913-3429
Mailing address
830 TARRAGON LN, SAN LUIS OBISPO, CA 93401-7264
(909) 913-3429
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
63418
CA
Other
Enumeration date
10/10/2012
Last updated
11/21/2022
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