Individual
NICOLE RENAE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2121 NORTH AVE, GRAND JUNCTION, CO 81501-6428
(970) 263-5062
Mailing address
553 GARFIELD DR APT 3, GRAND JUNCTION, CO 81504-5393
(970) 629-2891
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
7085689-9920
UT
124Q00000X
Dental Hygienist
Primary
905647
CO
Other
Enumeration date
10/12/2009
Last updated
10/12/2009
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