Individual
LISA HARTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
81 S MAIN ST, WARSAW, NY 14569
(585) 637-3905
(585) 637-4990
Mailing address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
024273
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598707812
MAIN NPI OF GROUP
NY
Enumeration date
09/10/2013
Last updated
09/10/2013
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