| NPI | 1295269710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT NELSON Dentist 518-439-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053538) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |