Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 047625-1 | NY |
NPI | 1053453423 |
---|---|
Provider Name | Dr. Joseph A. Sweet |
First Address | Cicero, NY 13039 |
Second Address | Cicero, NY 13039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |