Provider Demographics
NPI:1578765418
Name:EMANUEL GAMBACORTA DDS PC
Entity Type:Organization
Organization Name:EMANUEL GAMBACORTA DDS PC
Other - Org Name:DR GAMBACORTA & DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBACORTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-684-8882
Mailing Address - Street 1:750 DICK ROAD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225
Mailing Address - Country:US
Mailing Address - Phone:716-684-8882
Mailing Address - Fax:716-651-0110
Practice Address - Street 1:750 DICK ROAD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225
Practice Address - Country:US
Practice Address - Phone:716-684-8882
Practice Address - Fax:716-651-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty