# NORTHTOWNS ORAL & MAXILLOFACIAL SURGERY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427119601
- **Authorized official:** DR. CHAD L. BEATTY D.M.D., M.D. (VICE PRESIDENT)
- **Authorized official phone:** (716) 694-1134

## Contact information

- **Practice address:** 57 DAVISON CT., LOCKPORT, NY 14094
- **Practice address phone:** (716) 433-3822
- **Practice address fax:** (716) 433-9337
- **Mailing address:** 57 DAVISON CT., LOCKPORT, NY 14094
- **Mailing address phone:** (716) 433-3822
- **Mailing address fax:** (716) 433-9337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/12/2006
- **Last updated:** 08/22/2020