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1821613464
JONATHAN DAVID VALLECORSA
LATHAM, NY
NPI
1821613464
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: NY 062048)
Enumeration Date
2020-06-09
Last Update Date
2021-09-30
Business Address
JONATHAN DAVID VALLECORSA
4 SUNSET DR
LATHAM, NY 12110-2104
Phone number: 518-785-5100
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Mailing Address
JONATHAN DAVID VALLECORSA
4 SUNSET DR
LATHAM, NY 12110-2104
Phone number: 518-785-5100
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