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General NPI Number Information
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NPI Number | 1134910599
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Entity Type | Individual
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Provider Name | NICOLE KING RDH
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Gender | Female
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 876 N VAN DYKE RD
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City | BAD AXE
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State | MI
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Zip | 48413-9016
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Country | US
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Telephone | 989-331-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 8150 BLACK RD
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City | AKRON
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State | MI
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Zip | 48701-9779
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Country | US
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Telephone | 989-528-0314
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Fax | 989-528-0314
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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