| NPI | 1548304983 |
|---|---|
| Doing Business As | FALL CREEK FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | LUIS THELMO MAULEON President 607-272-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |