| NPI | 1427119601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD L. BEATTY Vice President 716-694-1134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |