| NPI | 1497934111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDAN CHADHA Owner 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS036997) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |