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NPI 1831249846

NPI 1831249846 : TODD R LEVINE DDS : LOCKPORT, NY

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General NPI Number Information
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    NPI Number           |    1831249846
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    Entity Type          |    Individual 
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    Provider Name        |    TODD R LEVINE DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/11/2007
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    Last Update Date     |    04/29/2017
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Provider Practice Location Address
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    Address Line         |    5862 SNYDER DRIVE 
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    City                 |    LOCKPORT
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    State                |    NY
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    Zip                  |    14094
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    Country              |    US
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    Telephone            |    716-439-1877
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    Fax                  |    716-439-1918
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Provider Business Mailing Address
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    Address Line         |    5862 SNYDER DR 
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    City                 |    LOCKPORT
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    State                |    NY
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    Zip                  |    14094-9497
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    Country              |    US
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    Telephone            |    716-439-1877
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    Fax                  |    716-439-1918
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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       |    042491
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    License Number State |    NY
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