Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
PORTVILLE DENTAL PLLC
Active
Organization
PORTVILLE DENTAL PLLC
Active
Other names
O. Boyce McDivitt,DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIN BOYCE MCDIVITT DDS (OWNER)
(716) 933-6787
Entity
Organization
Contact information
Practice address
149 S MAIN ST, PORTVILLE, NY 14770-9703
(716) 933-6787
(716) 933-0117
Mailing address
149 S MAIN ST, PORTVILLE, NY 14770-9703
(716) 933-6787
(716) 933-0117
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223G0001X
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005536000001
—
PA
05
—
00605445NY
—
NY
01
—
007700991
MCDIVITT BC BS
—
05
—
02386001NY
—
NY
01
—
1407844426
PETRYSZAK NPI
—
01
—
1962490987
MCDIVITT NPI
—
Enumeration date
05/09/2007
Last updated
06/15/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up