Individual
LUIZA KIYAMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
606 OLD ROUTE 17, MONTICELLO, NY 12701-7013
(845) 707-8483
Mailing address
5 SHORTCUT RD, COCHECTON, NY 12726-5316
(347) 705-2146
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
030692
NY
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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