Individual
DR. JOHN ANDREW HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
151 BUFFALO AVE, SUITE 208, NIAGARA FALLS, NY 14303-1243
(716) 285-6268
(716) 285-0066
Mailing address
151 BUFFALO AVE, SUITE 208, NIAGARA FALLS, NY 14303-1243
(716) 285-6268
(716) 285-0066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
047932
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000726469002
BLUE CROSS ID #
NY
05
—
02360474
—
NY
Enumeration date
01/05/2007
Last updated
07/09/2007
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