Individual
MISS PETAL CANDACE LEUWAISEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
530 1ST AVE, SUITE9 QQ, NEW YORK, NY 10016-6402
(121) 299-8989
Mailing address
989 E 108TH ST, SUITE 3C, BROOKLYN, NY 11236-3055
(718) 649-0818
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
022881
NY
Other
Enumeration date
11/01/2006
Last updated
09/25/2015
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