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5007 Transit Rd Depew NY 14043-4617 | |
| (716) 652-7080 | |
| (716) 206-0895 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 5007 Transit Rd, Depew, New York |
| Authorized Official Name and Position | Hannah Fish (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2175405699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5007 Transit Rd Depew NY 14043-4617 Ph: (716) 652-7080 | 5007 Transit Rd Depew NY 14043-4617 Ph: (716) 652-7080 |
| NPI Number | 1700109162 |
|---|---|
| Provider Enumeration Date | 03/12/2010 |
| Last Update Date | 01/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700109162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 047869 (New York) | Primary |
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