| NPI | 1770816985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHIYA BATTLE Provider Enrollment Manager 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 21101) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2009-09-08 |