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Individual

NICOLE WISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
8801 BRECKSVILLE RD, BRECKSVILLE, OH 44141-1947
(440) 725-9009
Mailing address
1271 W EDGERTON RD, BROADVIEW HEIGHTS, OH 44147-3005
(440) 725-9009

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH-11046
OH
174400000X
Specialist
Primary

Other

Enumeration date
01/15/2025
Last updated
01/15/2025
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