Individual
NICOLE DANIELLE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1701 W 72ND AVE, DENVER, CO 80221-2721
(303) 650-4460
Mailing address
1345 PLAZA CT N, #1A, LAFAYETTE, CO 80026-2832
(303) 665-3036
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
904468
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65952243
—
CO
Enumeration date
10/10/2005
Last updated
03/08/2012
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