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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. CECILIA JO HICKAM, RDH-EA, OMT

Active

Dental Hygienist · EAGLE, ID

Registration Details

NPI Number
1376940668
Provider Type
Individual
Gender
Female
NPI Issued
Dec 2, 2014 (11.393719261932 yrs)
Last Updated
Dec 2, 2014
License
DH-0356-EA (ID)

Practice Information

Address
1121 E. STATE STREET
SUITE - 102-D
EAGLE, ID, 83616
Browse ID providers · Browse ZIP 83616
Phone
2085849060
Primary Specialty
Dental Hygienist
124Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.