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Organization
TSA DENTAL PC
Active
Organization
TSA DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J LACARRUBBA (OWNER,CEO)
(716) 390-8185
Entity
Organization
Contact information
Practice address
7210 NORTH FOREST ROAD, AMHERST, NY 14068
(716) 707-3334
(716) 707-3334
Mailing address
7210 NORTH FOREST ROAD, GETZVILLE, NY 14068
(716) 707-3334
(716) 707-3334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
046843-1
NY
122300000X
Dentist
Primary
055792
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01751248
—
NY
05
—
03578943
—
NY
Enumeration date
07/26/2016
Last updated
07/26/2016
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