Richard Etengoff Dds Pc | |
1241 Colvin Ave Buffalo NY 14223 | |
(716) 877-5941 | |
(716) 877-8409 |
Full Name | Richard Etengoff Dds Pc |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 1241 Colvin Ave, Buffalo, New York |
Authorized Official Name and Position | Richard Alan Etengoff (PRESIDENT ORTHODONTIST) |
Authorized Official Contact | 7168775941 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Richard Etengoff Dds Pc 1241 Colvin Ave Buffalo NY 14223 Ph: (716) 877-5941 | Richard Etengoff Dds Pc 1241 Colvin Ave Buffalo NY 14223 Ph: (716) 877-5941 |
NPI Number | 1194911693 |
---|---|
Provider Enumeration Date | 09/18/2007 |
Last Update Date | 09/18/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194911693 | NPI | - | NPPES |
00695001 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0320981 (New York) | Primary |
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