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NPI Code Detail

MEDICARE: DR. JOEL MARK LEVIN DDS

MEDICARE: DR. JOEL MARK LEVIN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry026237NY

General Provider Information

NPI Number : 1760463244
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOEL MARK LEVIN DDS
Provider Business Mailing Address
First Line : 62 CHATHAM AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14216-3109
Country : US
Telephone Number : 716-885-0510
Fax Number :
Provider Business Practice Location Address
First Line : 1115 DELAWARE AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14209-1603
Country : US
Telephone Number : 716-885-0510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 07/08/2007

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Directions to “ DR. JOEL MARK LEVIN DDS” Practice Location

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