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1740772110
MARK COLLINSWORTH
PENN YAN, NY
NPI
1740772110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: NY 017629)
Enumeration Date
2018-06-01
Last Update Date
2018-06-01
Business Address
MARK COLLINSWORTH RDH
160 MAIN ST
PENN YAN, NY 14527-1204
Phone number: 315-531-9102
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Mailing Address
MARK COLLINSWORTH RDH
601B W WASHINGTON ST
GENEVA, NY 14456-2119
Phone number: 315-787-8151
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