| NPI | 1699075267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY SPADARO SPADARO CEO 518-688-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 041791) |
| Additional Taxonomies | 126900000X Dental Laboratory Technician |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2010-10-28 |