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Organization
STONE ROAD DENTAL
Active
Organization
STONE ROAD DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA J MAIOLO (OFFICE PERSONNEL)
(716) 635-4720
Entity
Organization
Contact information
Practice address
2107 KENSINGTON AVE, SNYDER, NY 14226-4807
(716) 635-4720
(716) 635-4724
Mailing address
2107 KENSINGTON AVE, SNYDER, NY 14226-4807
(716) 635-4720
(716) 635-4724
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049459-1
NY
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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