Individual
MRS. KERISA LYNNE MUFFOLETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
155 LAWN AVE, BUFFALO, NY 14207-1816
(716) 875-2904
Mailing address
5746 RIDGE RD, LOCKPORT, NY 14094-9408
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
027201-1
NY
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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