Healthcare Provider Details

I. General information

NPI: 1528260890
Provider Name (Legal Business Name): JOEL J BICKLER D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOEL J BICKLER D.D.S.

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 WEST BIG BEAR BLVD
BIG BEAR CITY CA
92314
US

IV. Provider business mailing address

PO BOX 250
BIG BEAR CITY CA
92314-0250
US

V. Phone/Fax

Practice location:
  • Phone: 909-585-7444
  • Fax: 909-585-6965
Mailing address:
  • Phone: 909-585-7444
  • Fax: 909-585-6965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: