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Organization

SOUTHTOWNS DENTAL SERVICES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN A D'ANGELO DDS (DENTIST/PRESIDENT)
(716) 825-5020
Entity
Organization

Contact information

Practice address
1497 ABBOTT ROAD, LACKAWANNA, NY 14218
(716) 825-5020
(716) 823-7115
Mailing address
1497 ABBOTT ROAD, LACKAWANNA, NY 14218
(716) 825-5020
(716) 823-7115

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0359351
NY
122300000X
Dentist
0410661
NY
122300000X
Dentist
047088
NY
122300000X
Dentist
1461621
NY
122300000X
Dentist
358761
NY
124Q00000X
Dental Hygienist
Primary
0056431
NY
124Q00000X
Dental Hygienist
010445
NY
124Q00000X
Dental Hygienist
0109281
NY
124Q00000X
Dental Hygienist
0160431
NY
124Q00000X
Dental Hygienist
0189991
NY
124Q00000X
Dental Hygienist
0225201
NY

Other

Enumeration date
08/13/2006
Last updated
09/11/2025
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