Most Relevant Information
Provider Data
| NPI Number: | 1003500976 |
| Provider Name: | IAN FOSS RDH |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 029202 |
Most Important Dates
| Enumeration Date: | 06/05/2023 |
| Last Updated: | 06/05/2023 |
Provider Practice Location
9864 LUCKEY DR
HOUGHTON
NY
147448706
Practice Location Phone/Fax
| Phone: | 7163757500 |
| Fax: | 7167016898 |
Provider Mailing Location
9864 LUCKEY DR
HOUGHTON
NY
147448706
Provider Mailing Phone/Fax
| Phone: | 7163757500 |
| Fax: | 7167016898 |