| NPI | 1811059892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WAY President 315-782-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 0314531) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |