| NPI | 1285893172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GURSIMRAT JUDGE Owner 315-798-1319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 045649) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |