Organization
UNIVERSITY PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSEANN MCANULTY M.S.A. (CHIEF OPERATING OFFICER)
(716) 688-7712
Entity
Organization
Contact information
Practice address
1100 MAIN STREET, BUFFALO, NY 14222
(716) 242-8200
Mailing address
1100 MAIN ST, BUFFALO, NY 14209-2308
(716) 242-8200
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01181424
—
NY
05
—
03376083
—
NY
Enumeration date
08/30/2006
Last updated
01/13/2012
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