DR. NICHOLAS G BENNETT, M.D.
Medical Practice at Marlette Cir, South Lake Tahoe, CA

License number
California ATE20131
Category
Medical Practice
Type
Ophthalmology
Address
Address
3250 Marlette Cir, South Lake Tahoe, CA 96156
Phone
(530) 542-0480
National Provider ID: 1619293727
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NICHOLAS G. BENNETT, M.D., INC

PO Box 173, S Lake Tahoe, CA 96156

Status:
Inactive
Registration:
Jun 2, 1980
State ID:
C0984408
Business type:
Articles of Incorporation
President:
Nicholas G. Bennett President, inactive
Agent:
Nicholas G Bennett,S Lake Tahoe, CA 95705 (Physical)

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