| NPI | 1235608720 |
|---|---|
| Doing Business As | CEDAR MOUNTAIN DENTAL |
| Entity Type | Organization |
| Authorized Contact | DARIA RENEE GAGLIARDI Operations 518-275-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2019-06-11 |