Individual
MIMI DENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 CRESCENT CT, CHEEKTOWAGA, NY 14225-3213
(716) 598-4399
Mailing address
10 CRESCENT CT, CHEEKTOWAGA, NY 14225-3213
(716) 598-4399
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
784812661
NY
172A00000X
Driver
—
NY
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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