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Organization
LOCKPORT DENTAL GROUP, P.C.
Active
Organization
LOCKPORT DENTAL GROUP, P.C.
Active
Other names
LDG Sleep Academy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD MITCHELL RETELL DDS (PRESIDENT)
(716) 433-6004
Entity
Organization
Contact information
Practice address
39 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 433-6004
(716) 433-7547
Mailing address
39 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 433-6004
(716) 433-7547
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
041617
NY
Other
Enumeration date
12/13/2006
Last updated
07/07/2015
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