Provider Demographics
NPI:1497076459
Name:HARITON, AMI JILL (DDS)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:JILL
Last Name:HARITON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-1634
Mailing Address - Country:US
Mailing Address - Phone:716-652-7080
Mailing Address - Fax:716-652-3465
Practice Address - Street 1:215 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-1634
Practice Address - Country:US
Practice Address - Phone:716-652-7080
Practice Address - Fax:716-652-3465
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist