| NPI | 1891020475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS B. NOLAN Owner 315-695-2128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 027837) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 027837) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2009-10-21 |