| Ub Oral & Maxillofacial Surgery, Inc | |
|
3435 Main St, 119 Squire Hall Buffalo NY 14214-1421 | |
| (716) 829-6637 | |
| (716) 829-2047 |
| Full Name | Ub Oral & Maxillofacial Surgery, Inc |
|---|---|
| Speciality | Dentist |
| Location | 3435 Main St, 119 Squire Hall, Buffalo, New York |
| Authorized Official Name and Position | John H Campbell (PRESIDENT) |
| Authorized Official Contact | 7168296032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ub Oral & Maxillofacial Surgery, Inc 3435 Main St 119 Squire Hall Buffalo NY 14214-3001 Ph: (716) 829-6637 | Ub Oral & Maxillofacial Surgery, Inc 3435 Main St, 119 Squire Hall Buffalo NY 14214-1421 Ph: (716) 829-6637 |
| NPI Number | 1902127335 |
|---|---|
| Provider Enumeration Date | 06/21/2010 |
| Last Update Date | 10/15/2020 |
| Medicare PECOS PAC ID | 4385813625 |
|---|---|
| Medicare Enrollment ID | O20110803000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902127335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Alfredo Aguirre |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1932298197 PECOS PAC ID: 6901086594 Enrollment ID: I20110215000333 |
| Provider Name | John H Campbell |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194768630 PECOS PAC ID: 1557531910 Enrollment ID: I20110823000670 |
| Provider Name | Richard E Hall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871606376 PECOS PAC ID: 0345410700 Enrollment ID: I20110823000698 |
| Provider Name | Michael Y Nagai |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1952621666 PECOS PAC ID: 5597050310 Enrollment ID: I20160818000771 |
| Provider Name | Robert L Cronyn |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1528016631 PECOS PAC ID: 4082834122 Enrollment ID: I20160825000930 |
| Provider Name | Michael R Markiewicz |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1225291347 PECOS PAC ID: 6507011152 Enrollment ID: I20170427000112 |
| Provider Name | Justin J Au |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1528222080 PECOS PAC ID: 0042452310 Enrollment ID: I20180627002902 |
| Provider Name | Vincent Mario Aquino |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1386179497 PECOS PAC ID: 8325316144 Enrollment ID: I20240731002557 |
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