Healthcare Provider Details

I. General information

NPI: 1902025133
Provider Name (Legal Business Name): DANIEL JAMES CONNY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 MAIN ST
BUFFALO NY
14214-3001
US

IV. Provider business mailing address

3 SMOKES CREEK RD
ORCHARD PARK NY
14127-2858
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-2862
  • Fax:
Mailing address:
  • Phone: 716-662-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number031529
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: