| NPI | 1013323583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIREILLE CRUZ President 315-469-1712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054191) |
| Enumeration Date | 2014-07-06 |
| Last Update Date | 2014-07-06 |