Individual
MADISON NICOLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
104 PLANTERS CT, ENTERPRISE, AL 36330-8581
(417) 496-5879
Mailing address
3455 S KINGS AVE, SPRINGFIELD, MO 65807-5119
(417) 496-5879
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2020016233
MO
124Q00000X
Dental Hygienist
H-0009209-C1
AL
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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