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General NPI Number Information
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NPI Number | 1366566523
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Entity Type | Organization
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Legal Business Name | FINGER LAKES ORTHODONTICS PC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2840 WESTINGHOUSE RD FINGER LAKES ORTHODONTICS PC
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City | HORSEHEADS
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State | NY
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Zip | 14845
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Country | US
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Telephone | 607-739-2551
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Fax | 607-739-8866
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Provider Business Mailing Address
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Address Line | 10921 CATON CREST
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City | CORNING
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State | NY
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Zip | 14830
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Country | US
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Telephone | 607-765-1233
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. PETER WALTER MAY
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Credential | DMD
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Telephone | 607-739-2551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0440811
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License Number State | NY
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