Individual
ISSA WISSAM DAOUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
231 WADE ROAD EXT STE 101, LATHAM, NY 12110-1855
(518) 782-1900
Mailing address
2302 HUDSON SQ # 2302, COHOES, NY 12047-3773
(514) 804-8942
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
063965
NY
Other
Enumeration date
09/14/2024
Last updated
09/14/2024
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