| NPI | 1275925380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J FANTUZZO Owner/Provider 585-203-1524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 048604) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-02-26 |