| NPI | 1679636336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA MOTTOLESE Vice President 518-459-4390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 033995) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2020-08-22 |