Individual
ELIZABETH ELLEN TACKETT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
40 WALL ST, NEW DIMENSIONS IN HEALTH CARE, AMSTERDAM, NY 12010
(518) 843-2575
(518) 843-3255
Mailing address
40 WALL ST, NEW DIMENSIONS IN HEALTH CARE, AMSTERDAM, NY 12010
(518) 843-2575
(518) 843-3255
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
51019428
NY
Other
Enumeration date
01/30/2006
Last updated
07/08/2007
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