Provider Demographics
NPI:1841651650
Name:APPLEGATE DENTAL, PLLC
Entity type:Organization
Organization Name:APPLEGATE DENTAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAINBROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-668-4646
Mailing Address - Street 1:2177 UNION RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1428
Mailing Address - Country:US
Mailing Address - Phone:176-668-4646
Mailing Address - Fax:
Practice Address - Street 1:2177 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1428
Practice Address - Country:US
Practice Address - Phone:176-668-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty