Individual
KELLIE A. SANZONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1114 WASHINGTON ST, WATERTOWN, NY 13601-4353
(315) 788-0122
Mailing address
1114 WASHINGTON ST, WATERTOWN, NY 13601-4353
(315) 788-0122
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
041279
NY
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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