| NPI | 1457661316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P WILSON President/Owner 607-238-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 50-052924) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2010-10-13 |