| Lake Shore Orthodontics & Oral Surgery Pc | |
|
415 Main Street Dunkirk NY 14048 | |
| (716) 366-8330 | |
| (716) 366-3077 |
| Full Name | Lake Shore Orthodontics & Oral Surgery Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 415 Main Street, Dunkirk, New York |
| Authorized Official Name and Position | James Theodore Strychalski (ORAL SURGEON) |
| Authorized Official Contact | 7163668330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Shore Orthodontics & Oral Surgery Pc 415 Main Street Dunkirk NY 14048 Ph: (716) 366-8330 | Lake Shore Orthodontics & Oral Surgery Pc 415 Main Street Dunkirk NY 14048 Ph: (716) 366-8330 |
| NPI Number | 1285885897 |
|---|---|
| Provider Enumeration Date | 10/02/2008 |
| Last Update Date | 10/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285885897 | NPI | - | NPPES |
| 006 22808 | Medicaid | NY | |
| 006 13438 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 031690-1 (New York) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 024679 (New York) | Primary |
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