| NPI | 1780715201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO JOHN MEROLA CEO 315-452-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 042450-1) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |