Individual
DOLORES LIBASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
(516) 378-2000
Mailing address
218 CORNWELL AVE, VALLEY STREAM, NY 11580-4746
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
00010098
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010098
—
NY
Enumeration date
08/01/2006
Last updated
07/08/2007
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