Individual
MARISSA L TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6815
(315) 298-1933
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6815
(315) 298-1933
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
026252-1
NY
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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