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Individual

ANDREW L MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9650 MAIN ST, CLARENCE, NY 14031
(716) 759-8323
(716) 759-0935
Mailing address
1491 SHERIDAN DR, KENMORE, NY 14217
(716) 875-0405
(716) 875-9620

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
042239
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01284826
NY
Enumeration date
08/29/2007
Last updated
08/29/2007
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