| NPI | 1962856237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN ROBERT MITCHELL Owner 716-909-4775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 056041) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-04-22 |