Provider Demographics
NPI:1790881423
Name:SCHRAGER, NICU SORIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICU
Middle Name:SORIN
Last Name:SCHRAGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:41593 WINCHESTER RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4860
Mailing Address - Country:US
Mailing Address - Phone:951-296-3366
Mailing Address - Fax:951-296-3377
Practice Address - Street 1:41593 WINCHESTER RD
Practice Address - Street 2:SUITE 211
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4860
Practice Address - Country:US
Practice Address - Phone:951-296-3366
Practice Address - Fax:951-296-3377
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA381281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice