| Jody Wicks, D.d.s., Inc. | |
|
6915 Reseda Blvd Suite 2 Reseda CA 91335-4214 | |
| (818) 881-8820 | |
| Not Available |
| Full Name | Jody Wicks, D.d.s., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6915 Reseda Blvd, Reseda, California |
| Authorized Official Name and Position | Jody Wicks (DENTIST) |
| Authorized Official Contact | 8188818820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jody Wicks, D.d.s., Inc. 6915 Reseda Blvd Suite 2 Reseda CA 91335-4214 Ph: (818) 881-8820 | Jody Wicks, D.d.s., Inc. 6915 Reseda Blvd Suite 2 Reseda CA 91335-4214 Ph: (818) 881-8820 |
| NPI Number | 1912054107 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912054107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 033685 (California) | Primary |
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