| NPI | 1710079371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERHART A BEUTTENMULLER Secretary 315-265-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 0345831) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |