| NPI | 1346793197 |
|---|---|
| Other Name | NICOLE MARIE JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE6061562) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 60671562) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2024-09-26 |