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Individual

DR. ANTHONY G. PETRILLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
348 ABBOTT RD, BUFFALO, NY 14220-1602
(716) 823-3030
Mailing address
348 ABBOTT RD, BUFFALO, NY 14220-1602
(716) 823-3030

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049131
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02658304
NY
Enumeration date
11/30/2006
Last updated
04/01/2014
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