| NPI | 1568982049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW L MACDONALD Owner 716-759-8323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 042239) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2017-06-26 |