Organization
MEDINA DENTAL PLLC
Active
Other names
Lockport Dental Group PC d/b/s Medina Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN BARRY STOCKTON D.D.S. (OWNER/DENTIST)
(585) 798-0100
Entity
Organization
Contact information
Practice address
610 PARK AVE, MEDINA, NY 14103-1022
(585) 798-0100
(585) 798-3297
Mailing address
610 PARK AVE, MEDINA, NY 14103-1022
(585) 798-0100
(585) 798-3297
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
32240
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497830483
—
NY
Enumeration date
11/19/2014
Last updated
11/16/2022
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