Individual
PRAMOD PHILIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 SQUIRE HALL, BUFFALO, NY 14214-8006
(716) 829-6189
Mailing address
110 SPRING MEADOW DR APT 10, BUFFALO, NY 14221-8422
(216) 246-1576
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
000108
NY
Other
Enumeration date
06/27/2016
Last updated
02/17/2020
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