Individual
DR. NICOLE LAMBERT HURCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
51584 STATE ROAD 933, SOUTH BEND, IN 46637-1704
(574) 272-6575
(574) 272-6587
Mailing address
51584 STATE ROAD 933, SOUTH BEND, IN 46637-1704
(574) 272-6575
(574) 272-6587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12010971A
IN
1223G0001X
General Practice Dentistry
Primary
12010971A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200884210
—
IN
Enumeration date
05/30/2007
Last updated
09/11/2014
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