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Individual

J NICHOLAS PORCELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
LIONEL R. JOHN HEALTH CENTER, 987 RC HOAG DR, SALAMANCA, NY 14779
(716) 945-5894
(716) 945-5889
Mailing address
LIONEL R. JOHN HEALTH CENTER, 987 RC HOAG DR, SALAMANCA, NY 14779
(716) 945-5894
(716) 945-5889

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051311
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00001783898
UNITED CONCORDIA
NY
01
00025887504
UNIVERA/HEALTHPLEX
NY
01
000527781001
BC/BS OF WNY
NY
Enumeration date
05/04/2006
Last updated
12/30/2016
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