| NPI | 1114041019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNE TRIANA Dentist 315-789-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 041852) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2020-08-22 |