| NPI | 1538691803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE NICOLE MEGNA-ACORLOR Owner 716-249-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 056299) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 055802) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |