| NPI | 1144730649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL CREIGHTON Member 716-688-7712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 040579) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 057971) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 31086) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 045762) | |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 058438) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 050946) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2018-03-17 |