| NPI | 1104186733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH FERTUCCI President 845-897-2097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 9987) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |