| NPI | 1659688109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA OLIVERI Practice Administrator 716-282-4641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 044763-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 047088-1) |
| Enumeration Date | 2010-09-04 |
| Last Update Date | 2010-09-04 |