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General NPI Number Information
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NPI Number | 1013229343
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Entity Type | Organization
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Legal Business Name | KACALSKIANDHANNON DDS PLLC
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 3448 NIAGARA FALLS BLVD
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-1244
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Country | US
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Telephone | 716-807-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 3448 NIAGARA FALLS BLVD
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-1244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | CHRISTOPHER KACALSKI
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Credential | DDS
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Telephone | 716-863-0849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 046471
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License Number State | NY
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