Individual
DR. MATTHEW EDWARD FORTNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10261 ROUTE 60, SUITE 2, FREDONIA, NY 14063-1419
(716) 672-2002
(716) 672-2012
Mailing address
3478 STONE QUARRY RD, FREDONIA, NY 14063-9791
(716) 672-2270
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
053346
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03376905
—
NY
Enumeration date
04/17/2007
Last updated
05/15/2025
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