| NPI | 1124360599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR OMAR COLON Dentist 585-236-3135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053007) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |