| NPI | 1295182798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LANPHERE Director Billing 315-253-7245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 058155) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |