Individual
JUDITH SANSONE EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 LARK DR, ALBANY, NY 12207-1300
(518) 465-4771
(518) 242-4770
Mailing address
42 WOODSTEAD RD, BALLSTON LAKE, NY 12019-1629
(518) 465-4771
(518) 242-4770
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
006833
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006833
LICENSE
NY
Enumeration date
02/06/2007
Last updated
07/08/2007
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