| NPI | 1124459896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET M REILLY Dental Hygienist 315-255-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 022944) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |