Nichole Ivanov, RDH, BS

NPI #1134863343 in Charlevoix, Michigan

Provider Information

NPI Number: 1134863343
Entity Type: Individual
Name: Nichole Ivanov, RDH, BS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dental Hygienist
Credential: RDH, BS
Enumeration Date: Apr 24, 2022
Last Updated: Apr 24, 2022

Practice Location

Address: 220 W GARFIELD AVE
City: Charlevoix
State: Michigan
ZIP Code: 49720-1631
Phone: (231) 547-7620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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