Provider Demographics
NPI:1518128701
Name:ORCHARD PARK PROSTHODONTICS LLP
Entity Type:Organization
Organization Name:ORCHARD PARK PROSTHODONTICS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-662-7229
Mailing Address - Street 1:6435 WEBSTER RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1835
Mailing Address - Country:US
Mailing Address - Phone:716-662-7229
Mailing Address - Fax:716-662-7263
Practice Address - Street 1:6435 WEBSTER RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1835
Practice Address - Country:US
Practice Address - Phone:716-662-7229
Practice Address - Fax:716-662-7263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty