Provider Demographics
NPI:1265622872
Name:PROTO, DONALD ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ANTHONY
Last Name:PROTO
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 1:418 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2542
Mailing Address - Country:US
Mailing Address - Phone:716-373-2626
Mailing Address - Fax:
Practice Address - Street 1:418 W STATE ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2542
Practice Address - Country:US
Practice Address - Phone:716-373-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice