| NPI | 1720585391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA J CORNELIUS Practice Manager/Administrator 845-782-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 44464) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |