| NPI | 1154703288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY LOUISE RUCHLIN Business Manager 716-693-9077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 052405) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 054753) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |