Provider Demographics
NPI:1194135731
Name:METROPOLITAN DENTAL PLLC
Entity type:Organization
Organization Name:METROPOLITAN DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ERASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-854-7811
Mailing Address - Street 1:BRISBANE BLDG
Mailing Address - Street 2:403 MAIN ST
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-2109
Mailing Address - Country:US
Mailing Address - Phone:716-854-7811
Mailing Address - Fax:716-332-0119
Practice Address - Street 1:BRISBANE BLDG
Practice Address - Street 2:403 MAIN ST
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-2109
Practice Address - Country:US
Practice Address - Phone:716-854-7811
Practice Address - Fax:716-332-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty