Individual
ELLEN NORMA DENISE GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41277 COUNTY ROUTE 15, THERESA, NY 13691-2028
(315) 921-6684
Mailing address
41277 COUNTY ROUTE 15, THERESA, NY 13691-2028
(315) 921-6684
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
030565-01
NY
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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