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1376940668
CECILIA JO HICKAM
EAGLE, ID
NPI
1376940668
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: ID DH-0356-EA)
Enumeration Date
2014-12-02
Last Update Date
2014-12-02
Business Address
Mrs. CECILIA JO HICKAM RDH-EA, OMT
1121 E. STATE STREET SUITE - 102-D
EAGLE, ID 83616
Phone number: 208-584-9060
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Mailing Address
Mrs. CECILIA JO HICKAM RDH-EA, OMT
1121 E. STATE STREET SUITE 102-D
EAGLE, ID 83616
Phone number: 208-584-9060
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