Provider Demographics
NPI:1598961302
Name:JAMES A. HODDICK, D.D.S. & THOMAS J. BALAZS, D.D.S., L.L.P.
Entity Type:Organization
Organization Name:JAMES A. HODDICK, D.D.S. & THOMAS J. BALAZS, D.D.S., L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:HODDICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-692-4242
Mailing Address - Street 1:432 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-3946
Mailing Address - Country:US
Mailing Address - Phone:716-692-4242
Mailing Address - Fax:716-694-5774
Practice Address - Street 1:432 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-3946
Practice Address - Country:US
Practice Address - Phone:716-692-4242
Practice Address - Fax:716-694-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0401471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty