| NPI | 1225464910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY HUANG Member 315-516-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055633) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 10683) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2015-05-12 |