| NPI | 1982729091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN C KASSAB Owner Dentist 315-472-3414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 0443351) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |