| NPI | 1932552775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BAUMLER Dentist 716-308-3569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.030764) |
| Enumeration Date | 2016-07-17 |
| Last Update Date | 2016-07-17 |