Individual
NICOLE NONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13051 S US HIGHWAY 71, GRANDVIEW, MO 64030-2525
(816) 966-9450
Mailing address
717 BROADWAY BLVD APT 214S, KANSAS CITY, MO 64105-2092
(314) 604-7103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2018019392
MO
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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