| NPI | 1043334352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDWARD DAMIANO Secretary 315-455-7079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 040344) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-01-22 |