| NPI | 1730579566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZINA A. BERRY 50 Percent Owner/ Dentist 315-316-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 047689) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NY 051526) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |