Provider Demographics
NPI:1669522702
Name:FENIGSTEIN, STEWART M (DDS PC)
Entity type:Individual
Prefix:DR
First Name:STEWART
Middle Name:M
Last Name:FENIGSTEIN
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5214 MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-565-3900
Mailing Address - Fax:716-565-3330
Practice Address - Street 1:5214 MAIN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-565-3900
Practice Address - Fax:716-565-3330
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0400581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice