| NPI | 1093845430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA M. ANDERSON Office Manager 315-676-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 40049) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |