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DR. CASEY ANNE TENNISWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
532 MOE RD, CLIFTON PARK, NY 12065-3822
(518) 373-1181
(518) 348-6517
Mailing address
532 MOE RD, CLIFTON PARK, NY 12065-3822
(518) 373-1181
(518) 348-6517

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901019567
MI
1223P0221X
Pediatric Dentistry
Primary
054477-1
NY

Other

Enumeration date
08/01/2009
Last updated
08/01/2009
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