| NPI | 1790290294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ALLEN PFISTER Owner 315-724-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 38859) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |