Individual
NICHOLE FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
755 SCOTT CIR, JBPHH, HI 96853-5399
(808) 448-6371
Mailing address
1993 AAMAKA PL, PEARL CITY, HI 96782-1302
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1493
HI
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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