NPI | 1235880048 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIK G HAGEMAN President 518-456-7673 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223P0300X Dentist, Periodontics |
Enumeration Date | 2022-01-13 |
Last Update Date | 2022-01-13 |