| NPI | 1144377482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN E LOPEZ-ROSARIO Owner 315-592-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052831-1) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2018-05-09 |