Nicholas Thacker DDS INC

NPI #1407158876 in Santee, California

Provider Information

NPI Number: 1407158876
Entity Type: Organization
Organization Name: Nicholas Thacker DDS INC
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 17, 2010
Last Updated: Nov 17, 2010

Practice Location

Address: 8770 CUYAMACA ST STE 1
City: Santee
State: California
ZIP Code: 92071-4282
Phone: (619) 449-6555

Authorized Official

Name: DR. NICHOLAS ADAM THACKER, D.D.S.
Title: OWNER
Phone: (619) 449-6555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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