| NPI | 1235506635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH T NISTA Dentist 518-435-0462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 040184) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |