| Tsa Dental Pc | |
|
7210 North Forest Road Amherst NY 14068 | |
| (716) 707-3334 | |
| (716) 707-3334 |
| Full Name | Tsa Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 7210 North Forest Road, Amherst, New York |
| Authorized Official Name and Position | Robert J Lacarrubba (OWNER,CEO) |
| Authorized Official Contact | 7163908185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tsa Dental Pc 7210 North Forest Road Getzville NY 14068 Ph: (716) 707-3334 | Tsa Dental Pc 7210 North Forest Road Amherst NY 14068 Ph: (716) 707-3334 |
| NPI Number | 1386197358 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 07/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386197358 | NPI | - | NPPES |
| 01751248 | Medicaid | NY | |
| 03578943 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 046843-1 (New York) | Secondary |
| 122300000X | Dentist | 055792 (New York) | Primary |
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