Individual
NICOLE MARIE ANN FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
1377 S DORA ST, UKIAH, CA 95482-6512
(916) 388-4173
Mailing address
200 BOURBON LN, UKIAH, CA 95482-6802
(916) 388-4173
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1123
CA
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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