NPI 1124736723

Samantha Anne Nicolello, RDH

Practitioner Specialist Meridian, ID

Practice location

Address: 4044 N Legacy Woods Ave, Meridian, ID 83646-4480
Phone: (208) 871-0760

Registered specialties (2)

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence DH-3204 (ID)

Other Specialist providers in Idaho →

Dental Hygienist

Dental Providers Taxonomy 124Q00000X Licence DH-3204 (ID)

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Registry record

NPI: 1124736723
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Nov 2022
Record last updated: 11 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.