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General NPI Number Information
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NPI Number | 1508053711
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Entity Type | Organization
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Legal Business Name | LB ORTHODONTICS
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 6501 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1427
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Country | US
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Telephone | 716-689-0313
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Fax | 716-689-0314
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Provider Business Mailing Address
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Address Line | 6501 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1427
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Country | US
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Telephone | 716-689-0313
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Fax | 716-689-0314
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JUDITH LAMPASSO
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Credential | DDS
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Telephone | 716-689-0313
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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 | 045093-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 053373-1
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License Number State | NY
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