Organization
FREDONIA PEDIATRIC AND ADOLESCENT DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE LUKASIK (PEDIATRIC DENTIST)
(716) 672-2854
Entity
Organization
Contact information
Practice address
10433 CHRISTY RD, FREDONIA, NY 14063-9788
(716) 672-2854
(716) 672-5269
Mailing address
10433 CHRISTY RD, FREDONIA, NY 14063-9788
(716) 672-2854
(716) 672-5269
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
045656
NY
Other
Enumeration date
10/12/2016
Last updated
10/15/2019
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