| Lakewood Pediatric Dentistry Pllc | |
|
133 E Fairmount Ave Ste 1 Lakewood NY 14750-1950 | |
| (716) 763-0130 | |
| Not Available |
| Full Name | Lakewood Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 133 E Fairmount Ave Ste 1, Lakewood, New York |
| Authorized Official Name and Position | Jan Carlson (OWNER/DENTIST) |
| Authorized Official Contact | 7167630130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Pediatric Dentistry Pllc 133 E Fairmount Ave Ste 1 Lakewood NY 14750-1950 Ph: (716) 763-0130 | Lakewood Pediatric Dentistry Pllc 133 E Fairmount Ave Ste 1 Lakewood NY 14750-1950 Ph: (716) 763-0130 |
| NPI Number | 1417499500 |
|---|---|
| Provider Enumeration Date | 11/07/2016 |
| Last Update Date | 11/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417499500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 058246 (New York) | Primary |
Southern Tier Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 E Fairmount Ave, Lakewood, NY 14750 Phone: 716-763-6823 Fax: 716-763-0341 | |
Mondovi Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 E Fairmount Ave, Lakewood, NY 14750 Phone: 716-763-9838 |