Individual
ELIZABETH BAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
935 HOMESTEAD AVE, MAYBROOK, NY 12543-1311
(845) 427-5419
Mailing address
935 HOMESTEAD AVE, MAYBROOK, NY 12543-1311
(845) 427-5419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
040569-1
NY
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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