| Southern Tier Dentistry | |
|
133 E Fairmount Ave Lakewood NY 14750-1950 | |
| (716) 763-6823 | |
| (716) 763-0341 |
| Full Name | Southern Tier Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 133 E Fairmount Ave, Lakewood, New York |
| Authorized Official Name and Position | Winchester Logan Stuart (PARTNER) |
| Authorized Official Contact | 7167636823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Tier Dentistry 133 E Fairmount Ave Lakewood NY 14750-1950 Ph: (716) 763-6823 | Southern Tier Dentistry 133 E Fairmount Ave Lakewood NY 14750-1950 Ph: (716) 763-6823 |
| NPI Number | 1083195754 |
|---|---|
| Provider Enumeration Date | 08/22/2018 |
| Last Update Date | 08/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083195754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Mondovi Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 E Fairmount Ave, Lakewood, NY 14750 Phone: 716-763-9838 | |
Lakewood Pediatric Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 E Fairmount Ave Ste 1, Lakewood, NY 14750 Phone: 716-763-0130 |