| NPI | 1518047166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT PANUCCI Practice Manager 518-445-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-02-29 |