| NPI | 1083777106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R SHAKUN President 607-723-8377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 033411) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 027028) |
| 1223G0001X Dentist, General Practice (Licence: NY 044401) | |
| 1223G0001X Dentist, General Practice (Licence: NY 048942) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2012-09-20 |