Individual
MRS. JUDITH ANN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4 COMMERCE LANE, CANTON, NY 13617
(315) 386-8191
(315) 386-1410
Mailing address
4 COMMERCE LANE, CANTON, NY 13617
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
014029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01995615
—
NY
Enumeration date
03/10/2010
Last updated
03/10/2010
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