Healthcare Provider Details

I. General information

NPI: 1699895706
Provider Name (Legal Business Name): PAUL RICHARD CREIGHTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 BRYANT ST
BUFFALO NY
14222-2006
US

IV. Provider business mailing address

276 DONCASTER RD
KENMORE NY
14217-2110
US

V. Phone/Fax

Practice location:
  • Phone: 716-878-7758
  • Fax:
Mailing address:
  • Phone: 716-861-3502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number040579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: