Individual
ERIC A POLISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 ELM STREET, GENEVA, NY 14456
(315) 781-2002
(315) 781-2422
Mailing address
30 ELM STREET, GENEVA, NY 14456
(315) 781-2002
(315) 781-2422
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
50051566
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02571011
—
NY
Enumeration date
04/06/2007
Last updated
07/08/2007
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