| NPI | 1003137381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC GREGORY JOHNSON Oral Surgeon 585-472-6326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 048311) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-07-19 |