| NPI | 1780109397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP H SHIN General Dentist 607-351-4520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS041136) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |