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NPI Code Detail

MEDICARE: DR. PAUL MICHAEL CHLOSTA D.M.D.

MEDICARE: DR. PAUL MICHAEL CHLOSTA D.M.D.
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
11223G0001XGeneral Practice Dentistry39357NY

General Provider Information

NPI Number : 1649280447
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL MICHAEL CHLOSTA D.M.D.
Provider Business Mailing Address
First Line : 3040 AMSDELL RD
Second Line :
City : HAMBURG
State : NY
Zip : 14075-5835
Country : US
Telephone Number : 716-648-6156
Fax Number : 716-648-6156
Provider Business Practice Location Address
First Line : 3040 AMSDELL RD
Second Line :
City : HAMBURG
State : NY
Zip : 14075-5835
Country : US
Telephone Number : 716-648-6156
Fax Number : 716-648-6156
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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