NPI | 1558691972 |
---|---|
Entity Type | Organization |
Authorized Contact | PETALROSE WENHAM-CLARK Practice Owner 518-218-7792 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 045037-1) |
Enumeration Date | 2010-01-07 |
Last Update Date | 2010-01-07 |