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General NPI Number Information
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NPI Number | 1538344197
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Entity Type | Organization
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Legal Business Name | RICHARD M COSTANTINI, D.D.S., P.C.
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 1050 ABBOTT RD
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City | BUFFALO
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State | NY
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Zip | 14220-2400
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Country | US
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Telephone | 716-822-6055
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Fax | 716-822-0592
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Provider Business Mailing Address
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Address Line | 1050 ABBOTT RD
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City | BUFFALO
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State | NY
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Zip | 14220-2400
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Country | US
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Telephone | 716-822-6055
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Fax | 716-822-0592
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. RICHARD MARIO COSTANTINI
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Credential | D.D.S.
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Telephone | 716-822-6055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 026346
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License Number State | NY
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