National Provider Identifier
Jack Su, D.D.S.
Jack Su, D.D.S. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Buffalo, NY and a listed phone number of (716) 875-3660.
Profile Overview
- NPI
- 1326134941
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- October 04, 2006
- Last Updated
- July 08, 2007
Practice Location
- 1950 Sheridan Dr.
- 5E
- Buffalo, NY 14223-1240
Phone: (716) 875-3660
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1326134941
- Entity Type
- Individual
- Last Name
- Su
- First Name
- Jack
- Name Prefix
- Dr.
- Credential
- D.D.S.
- Mailing Street Address
- 1950 Sheridan Dr.
- Mailing Address Line 2
- 5E
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14223-1240
- Mailing Country
- US
- Practice Street Address
- 1950 Sheridan Dr.
- Practice Address Line 2
- 5E
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14223-1240
- Practice Country
- US
- Practice Phone
- (716) 875-3660
- Enumeration Date
- October 04, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)
- Other Identifiers
- 02164125 (NY)