| NPI | 1003450735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON JONES Owner 716-649-5254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |