| NPI | 1518336924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEBEDIAH S CHRISTY Owner 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 8613) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-10-30 |