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Organization

PEDIATRIC DENTAL ASSOCIATES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL CREIGHTON DDS (MEMBER)
(716) 688-7712
Entity
Organization

Contact information

Practice address
1800 MAPLE RD STE 200, WILLIAMSVILLE, NY 14221-2749
(716) 688-7712
(716) 688-4719
Mailing address
1800 MAPLE RD STE 200, WILLIAMSVILLE, NY 14221-2749
(716) 688-7712

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
057971
NY
1223P0221X
Pediatric Dentistry
Primary
040579
NY
1223P0221X
Pediatric Dentistry
045762
NY
1223P0221X
Pediatric Dentistry
31086
NY
1223P0700X
Prosthodontics
058438
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
050946
NY

Other

Enumeration date
10/10/2017
Last updated
03/17/2018
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