Individual
NICOLE HAYDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00204298
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
107346
CA
Other
Enumeration date
09/01/2020
Last updated
05/03/2022
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