| NPI | 1124414537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEMARI DE LEON IMAO Owner/Dentist 585-354-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412284) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2015-04-13 |