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Organization

TWICHELL AND LUKASIK DDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK L TWICHELL DDS (PARTNER)
(716) 672-2854
Entity
Organization

Contact information

Practice address
85 W MAIN ST, FREDONIA, NY 14063
(716) 672-2854
(716) 672-5269
Mailing address
85 W MAIN ST, FREDONIA, NY 14063
(716) 672-2854
(716) 672-5269

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
032849
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01049536
NY
Enumeration date
11/07/2007
Last updated
11/07/2007
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