| NPI | 1275720971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER MORTELLITI Owner 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 13263) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |