Individual
MS. SANDRA A WHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDA-RDA
Contact information
Practice address
790 RIDGE RD, LACKAWANNA, NY 14218-1629
(716) 828-9334
Mailing address
39 N SHORE DR, BLASDELL, NY 14219-2310
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
000706
NY
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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