| NPI | 1043350200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE M. BAILEY Office Manager 315-446-3360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 037046) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |