Provider Demographics
NPI:1205987708
Name:DOWD, BRENDAN PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:PATRICK
Last Name:DOWD
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 1:115 DEERHURST PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2157
Mailing Address - Country:US
Mailing Address - Phone:716-873-8457
Mailing Address - Fax:716-874-3958
Practice Address - Street 1:6932 WILLIAMS RD
Practice Address - Street 2:1900
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-3071
Practice Address - Country:US
Practice Address - Phone:716-297-1675
Practice Address - Fax:716-297-1676
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040345-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice