| NPI | 1104136746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS B O'HARA Owner 518-562-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 0349871) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |