| NPI | 1891112207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRIE IVY Business Manager 585-381-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0366441) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2021-05-26 |