| NPI | 1043584196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALAN MELTZER President 315-637-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 029435) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |