| Nicole M Jane, Dds, Ms, Pc | |
|
965 Tahoe Keys Blvd South Lake Tahoe CA 96150-7161 | |
| (530) 541-6585 | |
| Not Available |
| Full Name | Nicole M Jane, Dds, Ms, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 965 Tahoe Keys Blvd, South Lake Tahoe, California |
| Authorized Official Name and Position | Nicole Marie Jane (ORTHODONTIST/PRESIDENT) |
| Authorized Official Contact | 5305416585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole M Jane, Dds, Ms, Pc 965 Tahoe Keys Blvd South Lake Tahoe CA 96150-7161 Ph: (530) 541-6585 | Nicole M Jane, Dds, Ms, Pc 965 Tahoe Keys Blvd South Lake Tahoe CA 96150-7161 Ph: (530) 541-6585 |
| NPI Number | 1073840039 |
|---|---|
| Provider Enumeration Date | 11/12/2009 |
| Last Update Date | 11/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073840039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 53320 (California) | Primary |
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