| NPI | 1194084061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD R LEVINE Owner 716-439-1877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2019-09-26 |