Search › Idaho › 174400000X
Samantha Nicolello, RDH
NPI 1124736723 · on the registry since 2022 · sole proprietor
Practice
- Address
- 4044 N Legacy Woods Ave
Meridian, ID 83646 - Phone
- (208) 871-0760
Registry record
- Primary taxonomy
- 174400000X
174400000X
- Also registered as
- 124Q00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-11-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho