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General NPI Number Information
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NPI Number | 1396877973
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Entity Type | Organization
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Legal Business Name | ORAL & MAXILLOFACIAL SURGERY ASSOCIATES OF WNY PC
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 1947 RIDGE RD
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City | WEST SENECA
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State | NY
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Zip | 14224-3339
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Country | US
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Telephone | 716-675-9777
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Fax | 716-675-9645
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Provider Business Mailing Address
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Address Line | 1947 RIDGE RD
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City | WEST SENECA
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State | NY
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Zip | 14224-3339
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Country | US
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Telephone | 716-675-9777
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Fax | 716-675-9645
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. DONNA LUH
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Credential |
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Telephone | 716-675-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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