Organization
WNY TMD & OROFACIAL PAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT STEPHEN KULL D. D. S. M. S. (PRESIDENT)
(716) 675-5858
Entity
Organization
Contact information
Practice address
4134 SENECA ST, WEST SENECA, NY 14224-3044
(716) 675-5858
(716) 675-4872
Mailing address
4134 SENECA ST, WEST SENECA, NY 14224-3044
(716) 675-5858
(716) 675-4872
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
028517
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4001292
INDEPENDENT HEALTH INS
NY
Enumeration date
08/07/2006
Last updated
08/22/2020
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