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Organization

CHOICE 1 DENTAL, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VASUKI THEVANAYAGAM DDS (PRESIDENT)
(716) 568-1163
Entity
Organization

Contact information

Practice address
2878 NIAGARA FALLS BLVD, AMHERST, NY 14228-2020
(716) 693-2861
Mailing address
2878 NIAGARA FALLS BLVD, AMHERST, NY 14228-2020
(716) 693-2861

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049037
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0015696
DORAL
NY
05
02122003
NY
Enumeration date
04/20/2007
Last updated
08/22/2020
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