MEDICARE: DR. SALVATORE ORTOLANO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	045845-1	NY

General Provider Information

NPI Number	:	1043353741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVATORE ORTOLANO D.D.S.

Provider Business Mailing Address
First Line	:	9054 WINDING CREEK LN
Second Line	:
City	:	CLARENCE CENTER
State	:	NY
Zip	:	14032-9381
Country	:	US
Telephone Number	:	716-741-9448
Fax Number	:

Provider Business Practice Location Address
First Line	:	646 N FRENCH RD
Second Line	:	SUITE 8
City	:	BUFFALO
State	:	NY
Zip	:	14228-2100
Country	:	US
Telephone Number	:	716-691-3520
Fax Number	:	716-691-3742

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/08/2007

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