Individual
NICHOLETTE CONGDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 E KNOLES DRIVE, FLAGSTAFF, AZ 86011-0001
(928) 523-5122
Mailing address
6369 W POTTER DR, GLENDALE, AZ 85308-6606
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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