| Professional Dental Alliance Wm, Pllc | |
|
17 Long Ave Ste 107 Hamburg NY 14075-6200 | |
| (716) 655-5000 | |
| (716) 649-6623 |
| Full Name | Professional Dental Alliance Wm, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17 Long Ave Ste 107, Hamburg, New York |
| Authorized Official Name and Position | Erica Quinteros (CREDENTIALING) |
| Authorized Official Contact | 7249011964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Wm, Pllc 125 Enterprise Dr Ste 200 Pittsburgh PA 15275-1223 Ph: () - | Professional Dental Alliance Wm, Pllc 17 Long Ave Ste 107 Hamburg NY 14075-6200 Ph: (716) 655-5000 |
| NPI Number | 1962223198 |
|---|---|
| Provider Enumeration Date | 10/21/2024 |
| Last Update Date | 10/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962223198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Charles S. Travagliato, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4741 Camp Road, Hamburg, NY 14075 Phone: 716-646-9423 Fax: 716-646-9429 | |
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