Individual
CARRILYNN MAE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 MAIN ST, BINGHAMTON, NY 13905-2524
(607) 334-5366
(607) 336-1219
Mailing address
PO BOX 816, WHITNEY POINT, NY 13862-0816
(607) 745-4984
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0233051
NY
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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