Organization
CENTRAL SQUARE SMILES DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBER CUMMINGS RDH (OFFICE MANAGER)
(315) 638-0276
Entity
Organization
Contact information
Practice address
653 S MAIN ST, CENTRAL SQUARE, NY 13036
(315) 668-6261
Mailing address
653 S MAIN ST, CENTRAL SQUARE, NY 13036
(315) 668-6261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
03/26/2018
Last updated
03/26/2018
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