| NPI | 1477741635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LEE COMPO Office Manager 716-633-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 036938) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |