Individual
DR. CHARLES A MARCHETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5755 BROADWAY ST, LANCASTER, NY 14086-2357
(716) 683-0891
Mailing address
66 HILLCREST RD, EAST AURORA, NY 14052-1312
(716) 652-5543
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
034818-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00613754
—
NY
Enumeration date
11/22/2006
Last updated
07/09/2007
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