Individual
NICOLE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
70 MAIN ST, PORTER, ME 04068-3527
(207) 625-8126
Mailing address
70 MAIN ST, PORTER, ME 04068-3527
(207) 625-8126
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH4041
ME
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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