| NPI | 1134648017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRISTOW CART Sole Member 716-884-5909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 33608) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2022-07-21 |