| NPI | 1215257662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL THOMAS DAVEY President 518-561-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052618) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-13 |