| Family Dentistry Of Lyons, P.c | |
|
52 Broad St Lyons NY 14489-1154 | |
| (585) 229-2588 | |
| Not Available |
| Full Name | Family Dentistry Of Lyons, P.c |
|---|---|
| Speciality | Dentist |
| Location | 52 Broad St, Lyons, New York |
| Authorized Official Name and Position | Emmanuel Puddicombe (DENTIST/OWNER) |
| Authorized Official Contact | 5852292588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dentistry Of Lyons, P.c 52 Broad St Lyons NY 14489-1154 Ph: (585) 229-2588 | Family Dentistry Of Lyons, P.c 52 Broad St Lyons NY 14489-1154 Ph: (585) 229-2588 |
| NPI Number | 1417372269 |
|---|---|
| Provider Enumeration Date | 03/03/2014 |
| Last Update Date | 03/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417372269 | NPI | - | NPPES |
| 02605329 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 053364 (New York) | Primary |
Joseph J Russo Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 47 William St, Lyons, NY 14489 Phone: 315-946-6511 |