Organization
HILLVIEW FAMILY DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RUSSELL STASIAK D.D.S. (OWNER)
(716) 681-5468
Entity
Organization
Contact information
Practice address
6347 TRANSIT RD, DEPEW, NY 14043-1030
(716) 681-5468
(716) 706-1106
Mailing address
6347 TRANSIT RD, DEPEW, NY 14043-1030
(716) 681-5468
(716) 706-1106
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
037584
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02722778
—
NY
Enumeration date
06/26/2007
Last updated
10/02/2007
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