NPI | 1821838772 |
---|---|
Entity Type | Organization |
Authorized Contact | VALERIE HAMILTON Director, Provider Strategy 315-410-5531 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-05-29 |
Last Update Date | 2024-05-29 |