| NPI | 1750116497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE HAMILTON Directory, Payor Strategy 315-430-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-03 |