Individual
DR. KEVIN SCOTT MANZELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
4306 SENECA ST, WEST SENECA, NY 14224-3169
(716) 337-5066
(716) 677-5413
Mailing address
327 EUCLID AVE, KENMORE, NY 14217-2903
(716) 785-4684
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
059107-1
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
059107-1
NY
Other
Enumeration date
08/08/2017
Last updated
03/17/2018
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