| NPI | 1437494085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN FRANCIS JORDAN Owner 716-695-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 053904) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2022-08-19 |