| NPI | 1225916539 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | ALEXIS GHANEM AYOUBI Director 585-503-0713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |