| NPI | 1518367598 |
|---|---|
| Doing Business As | ASPEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIM VAN CAMP Provider Relations Specialist 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |