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Organization
KENMORE QUALITYCARE DENTISTRY, PC
Active
Organization
KENMORE QUALITYCARE DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J LACARRUBBA (PRESIDENT)
(716) 297-5500
Entity
Organization
Contact information
Practice address
956 KENMORE AVE, BUFFALO, NY 14216-1450
(716) 874-7112
(716) 874-7113
Mailing address
956 KENMORE AVE, BUFFALO, NY 14216-1450
(716) 874-7112
(716) 874-7113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP529003001
BC/BS CHILD HEALTH PLUS
NY
Enumeration date
03/18/2008
Last updated
07/21/2022
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