| Nicolas Dental Corporation | |
|
8003 Alicante Ave Lamont CA 93241-1712 | |
| (714) 906-9116 | |
| Not Available |
| Full Name | Nicolas Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8003 Alicante Ave, Lamont, California |
| Authorized Official Name and Position | Epifania Viola Nicolas (PRESIDENT/OWNER) |
| Authorized Official Contact | 7149069116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicolas Dental Corporation 8003 Alicante Ave Lamont CA 93241-1712 Ph: (714) 906-9116 | Nicolas Dental Corporation 8003 Alicante Ave Lamont CA 93241-1712 Ph: (714) 906-9116 |
| NPI Number | 1346605391 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 04/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346605391 | NPI | - | NPPES |
| B4029004 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 40290 (California) | Primary |
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