| NPI | 1942083852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN CUTLER Secretary 607-743-9474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2023-08-15 |