| NPI | 1356365902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN L. SMITH Practice Manager 518-482-6936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 029872) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |