Provider Demographics
NPI:1841167756
Name:DYER'S DENTAL GROUP PC
Entity type:Organization
Organization Name:DYER'S DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-505-6843
Mailing Address - Street 1:9515 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1914
Mailing Address - Country:US
Mailing Address - Phone:716-800-2319
Mailing Address - Fax:
Practice Address - Street 1:9515 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1914
Practice Address - Country:US
Practice Address - Phone:716-800-2319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DYER'S DENTAL GROUP PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty