Individual
JENNIFER BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1091 MAIN ST, BUFFALO, NY 14209-2305
(716) 242-8200
Mailing address
1155 MAIN ST APT 517, BUFFALO, NY 14209-2383
(905) 691-0259
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
063666
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/21/2018
Last updated
12/01/2023
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