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General NPI Number Information
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NPI Number | 1982465142
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Entity Type | Organization
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Legal Business Name | DENTIST ON SENECA PLLC
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 2233 SENECA ST
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City | BUFFALO
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State | NY
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Zip | 14210-2437
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Country | US
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Telephone | 716-823-2898
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Fax | 716-722-2220
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Provider Business Mailing Address
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Address Line | 2233 SENECA ST
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City | BUFFALO
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State | NY
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Zip | 14210-2437
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Country | US
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Telephone | 716-823-2898
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Fax | 716-722-2220
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JIN MAI-SOTO
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Credential | DDS
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Telephone | 716-823-2898
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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 |
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License Number State |
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