Individual
MR. KOSTACE LESLIE KYSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.H.
Contact information
Practice address
78 COMMONWEALTH, BUFFALO, NY 14216
(716) 297-0798
(716) 297-0998
Mailing address
78 COMMONWEALTH, BUFFALO, NY 14216
(716) 297-0798
(716) 297-0998
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
023835-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023835-1
NEW YORK STATE LICENSE
NY
Enumeration date
10/22/2010
Last updated
10/22/2010
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