Grant, Nicole Dominique
Grant, Nicole Dominique is an individual health care provider with primary practice located at 1461 Broadway St Apt A , Longview WA 98632-3724. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Grant, Nicole Dominique can be contacted via phone (855) 433-6825.Contact Information
Primary practice address
1461 Broadway St Apt A
Longview WA 98632-3724
Phone: (855) 433-6825
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DE60396563 | Washington |
Profile Details
| NPI number | 1497197941 |
|---|---|
| LBN Legal business name | Grant, Nicole Dominique |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2013 |
| Last updated | Aug 22nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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