Individual
DR. NICOLE A IIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1759 N RIVERSIDE AVE, MEDFORD, OR 97501-4628
(541) 227-5290
Mailing address
217 E MCANDREWS RD APT 219, MEDFORD, OR 97501-2058
(251) 401-8958
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12223
OR
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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