| NPI | 1982850517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARY WAGNER President 845-561-2494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053556-1) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |