33D1092675 CLIA NUMBER - DAVID W TODD DMD,MD

Laboratory Demographics

CLIA Number: 33D1092675

Facility Name: DAVID W TODD DMD,MD

Facility Address:
120 SOUTHWESTERN DRIVE
LAKEWOOD, NY
ZIP 14750
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Facility Phone Number: 716 484-8091

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194865907

Taxonomy: 1223S0112X - Dentist
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name	Field Value
CLIA Number	33D1092675
LAB Type	Physician Office
Facility Name	DAVID W TODD DMD,MD
Street	120 SOUTHWESTERN DRIVE
City	LAKEWOOD
State	NY
ZIP	14750
Phone	716 484-8091
CertificateType	4
CertificateEffectiveDate	12/2/2022
CertificateExpirationDate	12/1/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024