Provider Demographics
NPI:1275348203
Name:KOBRIC, DANIEL (BSC, DMD, MSC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:KOBRIC
Suffix:
Gender:M
Credentials:BSC, DMD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LISA CRES
Mailing Address - Street 2:
Mailing Address - City:THORNHILL
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L4J 2N2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3435 MAIN STREET
Practice Address - Street 2:250 SQUIRE HALL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-829-3845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0643801223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty