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General NPI Number Information
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NPI Number | 1467020925
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Entity Type | Individual
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Provider Name | NICOLE M MASSA R.D.H.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 7889 S LINCOLN CT
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City | LITTLETON
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State | CO
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Zip | 80122-2651
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Country | US
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Telephone | 303-798-4967
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Fax |
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Provider Business Mailing Address
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Address Line | 7006 S KENDALL BLVD
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City | LITTLETON
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State | CO
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Zip | 80128-3932
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Country | US
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Telephone |
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Fax |
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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 | 904067
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License Number State | CO
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