Provider Demographics
NPI:1043353741
Name:ORTOLANO, SALVATORE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:ORTOLANO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9054 WINDING CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9381
Mailing Address - Country:US
Mailing Address - Phone:716-741-9448
Mailing Address - Fax:
Practice Address - Street 1:646 N FRENCH RD
Practice Address - Street 2:SUITE 8
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14228-2100
Practice Address - Country:US
Practice Address - Phone:716-691-3520
Practice Address - Fax:716-691-3742
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045845-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice