Individual
DR. LOUIS A SURACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
37 PROFESSIONAL PKWY, LOCKPORT, NY 14094-5367
(716) 433-3364
(716) 433-7763
Mailing address
37 PROFESSIONAL PKWY, LOCKPORT, NY 14094-5367
(716) 433-3364
(716) 433-7763
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
041626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01273367
—
NY
Enumeration date
05/01/2006
Last updated
07/08/2007
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