| NPI | 1417049198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN C. LAURA President 315-438-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 042283) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |