Provider Demographics
NPI:1609849058
Name:MARGARONE, JOSEPH EDWARD III (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:EDWARD
Last Name:MARGARONE
Suffix:III
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 1:6490 MAIN ST
Mailing Address - Street 2:STE 3
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5853
Mailing Address - Country:US
Mailing Address - Phone:716-631-2800
Mailing Address - Fax:716-631-2814
Practice Address - Street 1:6490 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5853
Practice Address - Country:US
Practice Address - Phone:716-631-2800
Practice Address - Fax:716-631-2814
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0414851223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01339633Medicaid
NY11699CMedicare ID - Type Unspecified
NY01339633Medicaid