| NPI | 1679704431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE JAMES BUSINO Co Medical Director 518-446-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2015-02-23 |