| NPI | 1093960890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C RUTTER President 631-473-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 033761) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051054) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |