Individual
OLIVIA BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1519 NYE RD, LYONS, NY 14489-9133
(315) 871-3178
Mailing address
41 NORTH ST, MADRID, NY 13660-3128
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
028173
NY
Other
Enumeration date
08/19/2014
Last updated
08/20/2014
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