Organization
SENECA RIDGE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M CAPPUCCIO DDS (OWNER, DENTIST, MEMBER)
(716) 674-9444
Entity
Organization
Contact information
Practice address
3626 SENECA ST, WEST SENECA, NY 14224-3400
(716) 674-9444
Mailing address
3626 SENECA ST, WEST SENECA, NY 14224-3400
(716) 674-9444
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03971042
—
NY
05
—
1029678060001
—
PA
Enumeration date
09/27/2018
Last updated
09/27/2018
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