Individual
REBECCA ANN NICOSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6365 LAMAR TRL, FLORENCE, MT 59833-5947
(406) 544-9662
Mailing address
6365 LAMAR TRL, FLORENCE, MT 59833-5947
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1026
MT
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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