Individual
LISSETTE LOEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
12 THOMAS JEFFERSON PL, MIDDLETOWN, NY 10940-4511
(845) 467-0463
Mailing address
12 THOMAS JEFFERSON PL, MIDDLETOWN, NY 10940-4511
(845) 467-0463
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020087-1
NY
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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