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Organization
TSA DENTAL PC
Active
Organization
TSA DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAEL TRACY (OFFICE MANAGER)
(716) 707-3334
Entity
Organization
Contact information
Practice address
2700 N FOREST RD, GETZVILLE, NY 14068-1527
(716) 707-3334
Mailing address
2700 N FOREST RD, GETZVILLE, NY 14068-1527
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01751248
—
NY
05
—
02273614
—
NY
05
—
03578943
—
NY
Enumeration date
04/19/2016
Last updated
04/19/2016
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