| NPI | 1235676198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS JAMES CHAUVIN Owner 518-598-3086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 50051508) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |