Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 035058 | NY |
NPI | 1114234598 |
---|---|
Provider Name | Dr. Frank Leo Graziano JR. |
First Address | Williamsville, NY 14221-6046 |
Second Address | Williamsville, NY 14221-6046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 08/09/2010 |