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General NPI Number Information
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NPI Number | 1083610885
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Entity Type | Individual
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Provider Name | MICHAEL J. TABONE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 777 HOPKINS RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2320
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Country | US
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Telephone | 716-689-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 777 HOPKINS RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2320
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Country | US
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Telephone | 716-689-8882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 028599
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License Number State | NY
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