Organization
MACDONALD TYSKA & ALEXANDER ORTHODONTICS
Active
Organization
MACDONALD TYSKA & ALEXANDER ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW L MACDONALD MD (OWNER)
(716) 759-8323
Entity
Organization
Contact information
Practice address
1077 DELAWARE RD, TONAWANDA, NY 14223-1056
(716) 875-0405
Mailing address
9650 MAIN ST, CLARENCE, NY 14031-2004
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
042239
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871787259
—
NY
Enumeration date
06/26/2017
Last updated
06/26/2017
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