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Individual

NICOLE ANN MARIE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9598
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9598

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH2488
ID
124Q00000X
Dental Hygienist
Primary
H5241
OR

Other

Enumeration date
08/16/2013
Last updated
08/16/2013
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