| NPI | 1265780845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SRECA President 315-732-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 055997-1) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |