Individual
NIKOLE BREANNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1126 E AVENUE J2, LANCASTER, CA 93535-3949
(661) 317-9931
Mailing address
1126 E AVENUE J2, LANCASTER, CA 93535-3949
(661) 317-9931
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
26163
CA
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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