Individual
DR. LISA CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3557 UNION RD, BUFFALO, NY 14225-5123
(716) 651-0099
Mailing address
3500 SHERIDAN DR # 1548, BUFFALO, NY 14226-1548
(716) 655-5000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
058763-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04575077
—
NY
Enumeration date
06/24/2015
Last updated
08/23/2019
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