| NPI | 1255426805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT F CLARK Vice President 315-457-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 04614) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |