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General NPI Number Information
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NPI Number | 1043729239
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Entity Type | Organization
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Legal Business Name | HOWARD W. BENATOVICH, D.D.S., PC
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1281 UNION RD
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City | WEST SENECA
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State | NY
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Zip | 14224-2900
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Country | US
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Telephone | 716-675-5166
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Fax |
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Provider Business Mailing Address
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Address Line | 1281 UNION ROAD
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City | WEST SENECA
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State | NY
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Zip | 14224
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Country | US
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Telephone | 716-675-5166
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JULIE KOSCIELNY
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Credential |
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Telephone | 716-634-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 49544
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 27403
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License Number State | NY
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