Organization
JASMIN HENVILLE DMD - LIBSON PC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY CLUETT (PROVIDER ENROLLMENT SPECIALIST)
(315) 454-6000
Entity
Organization
Contact information
Practice address
193 RIVER RD STE 230, LISBON, CT 06351-3258
(860) 376-8800
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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