Individual
JULIE A HANAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDA
Contact information
Practice address
790 RIDGE RD, LACKAWANNA, NY 14218
(716) 828-9344
Mailing address
259 EMPORIUM AVE, WEST SENECA, NY 14224
(716) 827-5635
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
000804
NY
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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