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General NPI Number Information
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NPI Number | 1326269846
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Entity Type | Individual
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Provider Name | NICOLE TUCKER JOYNER DDS
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2711 S CENTRAL AVE
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City | LOS ANGELES
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State | CA
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Zip | 90011-5527
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Country | US
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Telephone | 323-231-2108
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Fax |
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Provider Business Mailing Address
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Address Line | 3971 HUBERT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90008-2619
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Country | US
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Telephone | 310-594-9509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 49553
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License Number State | CA
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