| NPI | 1639216690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J FIDLER Oral Surgeon 607-798-7169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 030712-1) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |