Etengoff, Richard Alan
Etengoff, Richard Alan is an sole proprietor health care provider with primary practice located at 1241 Colvin Ave , Buffalo NY 14223. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Etengoff, Richard Alan can be contacted via phone (716) 877-5941.Contact Information
Primary practice address
1241 Colvin Ave
Buffalo NY 14223
Phone: (716) 877-5941
Fax: (716) 877-8409
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 0320981 | New York |
Profile Details
| NPI number | 1841486412 |
|---|---|
| LBN Legal business name | Etengoff, Richard Alan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 18th, 2007 |
| Last updated | Sep 18th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841486412 | NPPES |
| New York | MEDICAID | 00695001 |
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