| NPI | 1649654237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME B AUSTRIACO Owner 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD D1065) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |