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JOEL JUSTIN NICHOLS D.M.D., M.H.A.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1265714174

Individual Registrant:
 JOEL JUSTIN NICHOLS D.M.D., M.H.A.
Gender: M
Sole Proprietor

Location and contact information for practice:
11132 W CALIFORNIA AVENUE  YOUNGTOWN, AZ 85363-1201 US
Tel: 623-565-2446  Fax: --

Contact information for business:
11132 W CALIFORNIA AVENUE  YOUNGTOWN, AZ 85363-1201 US
Tel: 623-565-2446  Fax: --

Registration Information:
NPI: 1265714174
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
AZD6673

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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