Provider Demographics
NPI:1851510283
Name:CALOS, DAVID J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:CALOS
Suffix:
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 1:79 N CAYUGA RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5417
Mailing Address - Country:US
Mailing Address - Phone:716-631-0720
Mailing Address - Fax:
Practice Address - Street 1:37 BATAVIA CITY CTR
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2107
Practice Address - Country:US
Practice Address - Phone:716-536-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0533551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice