Individual
BROOKE D NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, BS
Contact information
Practice address
195 W 14TH, RIFLE, CO 81650-4700
(970) 625-5200
Mailing address
PO BOX 7331, AVON, CO 81620-7331
(612) 799-1691
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
905457
CO
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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