| NPI | 1336413566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ROY LEVINE Owner 716-439-1877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 0424911) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |