| NPI | 1831229418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A. THOMAS DECKER President 518-489-8377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 0299761) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |