Individual
DR. NICOLE KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5022 4TH ST, BOULDER, CO 80304-4755
(646) 734-0866
Mailing address
5022 4TH ST, BOULDER, CO 80304-4755
(646) 734-0866
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
009435
CT
122300000X
Dentist
202182
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009435
STATE LICENSE
CT
01
—
202182
DENTAL LICENSE
CO
Enumeration date
12/02/2005
Last updated
12/03/2014
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