| NPI | 1982964516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH FERTUCCI President 845-897-2097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10723) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CT 10723) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |