Provider Demographics
NPI:1851301055
Name:NEWFANE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:NEWFANE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:GEISE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-778-7449
Mailing Address - Street 1:2727 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWFANE
Mailing Address - State:NY
Mailing Address - Zip Code:14108-1203
Mailing Address - Country:US
Mailing Address - Phone:716-778-7449
Mailing Address - Fax:716-778-0721
Practice Address - Street 1:2727 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWFANE
Practice Address - State:NY
Practice Address - Zip Code:14108-1203
Practice Address - Country:US
Practice Address - Phone:716-778-7449
Practice Address - Fax:716-778-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty