Organization
BOSTON DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ALAN MATLACH D.D.S. (OWNER)
(716) 941-5433
Entity
Organization
Contact information
Practice address
8397 BOSTON STATE RD, BOSTON, NY 14025-9651
(716) 941-5433
Mailing address
8397 BOSTON STATE RD, BOSTON, NY 14025-9651
(716) 941-5433
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
32221
NY
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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