| NPI | 1497177745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHREYAS INDRAVADAN PATEL CEO/Owner 315-652-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053048) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |