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Organization

LAKE SHORE ORTHODONTICS & ORAL SURGERY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES THEODORE STRYCHALSKI DDS (ORAL SURGEON)
(716) 366-8330
Entity
Organization

Contact information

Practice address
415 MAIN STREET, DUNKIRK, NY 14048
(716) 366-8330
(716) 366-3077
Mailing address
415 MAIN STREET, DUNKIRK, NY 14048
(716) 366-8330
(716) 366-3077

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
031690-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
024679
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006 13438
NY
05
006 22808
NY
Enumeration date
10/02/2008
Last updated
10/02/2008
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