# BUFFALO ROAD DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harborcreek Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407502537
- **Authorized official:** VICENTA REYES (LEAD OF CREDENTIALING)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 4820 BUFFALO RD, ERIE, PA 16510-2302
- **Practice address phone:** (814) 899-0444
- **Practice address fax:** (814) 898-2403
- **Mailing address:** PO BOX 734753, DALLAS, TX 75373-4753
- **Mailing address phone:** (814) 899-0444
- **Mailing address fax:** (814) 898-2403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2022
- **Last updated:** 02/12/2024