Organization
MARK TWICHELL & ANNETTE LUKASIK DDS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L TWICHELL DDS (PEDIATRIC DENTIST)
(716) 672-2854
Entity
Organization
Contact information
Practice address
85 WEST MAIN STREET, FREDONIA, NY 14063
(716) 672-2854
(716) 672-5269
Mailing address
85 WEST MAIN STREET, FREDONIA, NY 14063
(716) 672-2854
(716) 672-5269
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0456561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01549233
—
NY
05
—
02881670
—
NY
Enumeration date
11/20/2007
Last updated
11/20/2007
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