Organization
ST LAWERENCE ORAL AND MAXILLIOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERHART A BEUTTENMULLER DDS (SECRETARY)
(315) 265-1761
Entity
Organization
Contact information
Practice address
6604 STATE HIGHWAY 56, POTSDAM, NY 13676
(315) 265-1761
(315) 265-1768
Mailing address
6604 STATE HIGHWAY 56, POTSDAM, NY 13676
(315) 265-1761
(315) 265-1768
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0345831
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01456399
—
NY
Enumeration date
09/29/2006
Last updated
08/22/2020
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