| NPI | 1053478743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BOTTY Owner 315-458-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 031849-1) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |