Nicole M Jane, Dds, Ms, Pc

NPI 1073840039 - Clinic/Center - 261QD0000X

NPI Details
NPI 1073840039
Enumeration Date 11/12/2009
Last Updated 11/12/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name NICOLE MARIE NICOLE
Position ORTHODONTIST/PRESIDENT
Phone (530) 541-6585
Fax
Practice Location
965 TAHOE KEYS BLVD
SOUTH LAKE TAHOE CA, 96150-7161, US
Phone (530) 541-6585
Fax
Business Location
965 TAHOE KEYS BLVD
SOUTH LAKE TAHOE CA, 96150-7161, US
Phone (530) 541-6585
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State California
License Number 53320
Remove 1073840039 NPI Number
 

According to our database, Nicole M Jane, Dds, Ms, Pc NPI is 1073840039, taxonomy code is 261QD0000X and license number is 53320, license state is located at California. Nicole M Jane, Dds, Ms, Pc physically located at 965 Tahoe Keys Blvd, South Lake Tahoe CA, 96150-7161. NPI Number 1033115704 has the healthcare provider type.

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1073840039 NPI number is provided on an as is basis without warranty of any kind. 1073840039 is maintained by the National Plan & Provider Enumeration System. The contents of Nicole M Jane, Dds, Ms, Pc are for informational purposes only.