NPI 1376940668
Cecilia Jo Hickam, RDHEAOMT
Practice location
- Address
- 1121 E. State Street Suite - 102-D, Eagle, ID 83616
- Phone
- (208) 584-9060
- Mailing address
- 1121 E. State Street Suite 102-D, Eagle, ID 83616
Registered specialties
Dental Hygienist
Primary
Registry record
- NPI
- 1376940668
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 2 Dec 2014
- Record last updated
- 2 Dec 2014
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.