MEDICARE: EAST AURORA FAMILY DENTISTRY, P.C.

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1871465757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST AURORA FAMILY DENTISTRY, P.C.

Provider Business Mailing Address
First Line	:	250 QUAKER RD STE A
Second Line	:
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2167
Country	:	US
Telephone Number	:	716-655-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 QUAKER RD STE A
Second Line	:
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2167
Country	:	US
Telephone Number	:	716-655-3500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CALLIE WILLIAMS
Credential	:	DDS
Telephone Number	:	716-655-3500

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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