| Elmwood Village Dental Pc | |
|
892 Elmwood Ave Buffalo NY 14222-1494 | |
| (716) 332-0460 | |
| (716) 881-0449 |
| Full Name | Elmwood Village Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 892 Elmwood Ave, Buffalo, New York |
| Authorized Official Name and Position | Deborah Damico (CREDENTIALING LIAISON) |
| Authorized Official Contact | 7166469423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elmwood Village Dental Pc 2707 Sheridan Dr Tonawanda NY 14150-9466 Ph: (716) 646-9423 | Elmwood Village Dental Pc 892 Elmwood Ave Buffalo NY 14222-1494 Ph: (716) 332-0460 |
| NPI Number | 1659032639 |
|---|---|
| Provider Enumeration Date | 01/03/2022 |
| Last Update Date | 01/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659032639 | NPI | - | NPPES |
| 1235378803 | Other | NY | INDIVIDUAL NPI |
| 1467915165 | Other | NY | INDIVIDUAL NPI |
| 1831727882 | Other | NY | INDIVIDUAL NPI |
| 1942677539 | Other | NY | INDIVIDUAL NPI |
| 1417334293 | Other | NY | INDIVIDUAL NPI |
| 1295767598 | Other | NY | INDIVIDUAL NPI |
| 1124581251 | Other | NY | INDIVIDUAL NPI |
| 1154781326 | Other | NY | INDIVIDUAL NPI |
| 1356918080 | Other | NY | INDIVIDUAL NPI |
| 1447338686 | Other | NY | INDIVIDUAL NPI |
| 1720471063 | Other | NY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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