Provider Demographics
NPI:1053945360
Name:BUFFALO SLEEP CARE LLC
Entity type:Organization
Organization Name:BUFFALO SLEEP CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:716-634-4090
Mailing Address - Street 1:4427 UNION RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2305
Mailing Address - Country:US
Mailing Address - Phone:716-229-0494
Mailing Address - Fax:716-634-4136
Practice Address - Street 1:4427 UNION RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-2305
Practice Address - Country:US
Practice Address - Phone:716-229-0494
Practice Address - Fax:716-634-4136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty