Individual
DR. MARK L TWICHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
85 WEST MAIN ST, FREDONIA, NY 14063
(716) 672-2854
(716) 672-5269
Mailing address
85 WEST MAIN ST, FREDONIA, NY 14063
(716) 672-2854
(716) 672-5269
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
032849
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01049536
—
NY
Enumeration date
06/04/2006
Last updated
11/27/2012
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