| NPI | 1134501356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIDEON I OCHIABUTO Dentist 315-218-7366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053709-1) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2016-11-02 |