| NPI | 1225392855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY COLE Provider Relations Manager 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 9388) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2012-06-28 |