Provider Demographics
NPI:1700085677
Name:KENMORE DENTAL ASSOC. LLP
Entity Type:Organization
Organization Name:KENMORE DENTAL ASSOC. LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:D'ARRIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-874-1826
Mailing Address - Street 1:2835 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1330
Mailing Address - Country:US
Mailing Address - Phone:716-874-1826
Mailing Address - Fax:716-874-6226
Practice Address - Street 1:2835 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1330
Practice Address - Country:US
Practice Address - Phone:716-874-1826
Practice Address - Fax:716-874-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty