Organization
ACAHT IDENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETSY L. PETERSON D.M.D. (DR/VICE PRESIDENT)
(607) 272-2081
Entity
Organization
Contact information
Practice address
523 W CLINTON ST, ITHACA, NY 14850-5233
(607) 272-2081
Mailing address
523 W CLINTON ST, ITHACA, NY 14850-5233
(607) 272-2081
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/16/2015
Last updated
10/16/2015
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