Individual
DR. KATHLEEN J NUCKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10921 WILSHIRE BLVD, SUITE 1003, LOS ANGELES, CA 90024-3906
(310) 208-8273
(310) 208-0104
Mailing address
10921 WILSHIRE BLVD, SUITE 1003, LOS ANGELES, CA 90024-3906
(310) 208-8273
(310) 208-0104
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
29934
CA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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