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General NPI Number Information
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NPI Number | 1801736400
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Entity Type | Organization
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Legal Business Name | NICOLE M. ANCICH, DMD PLLC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 2208 N 30TH ST STE 201
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City | TACOMA
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State | WA
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Zip | 98403-3360
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Country | US
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Telephone | 253-383-5636
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Fax | 253-274-0604
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Provider Business Mailing Address
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Address Line | 2208 N 30TH ST STE 201
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City | TACOMA
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State | WA
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Zip | 98403-3360
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Country | US
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Telephone | 253-383-5636
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Fax | 253-274-0604
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | NICOLE M ANCICH
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Credential | DMD
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Telephone | 253-383-5636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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