| NPI | 1851430193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A CRAYBAS Dentist 3155-475-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 046443) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 031300) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |