Individual
JESSICA ELYSE CANALLATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
462 GRIDER ST, BUFFALO, NY 14215
(716) 898-1461
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
059063
NY
Other
Enumeration date
04/18/2016
Last updated
05/15/2018
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