National Provider Identifier

Ellyce Clonan, DDS

Ellyce Clonan, DDS is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Buffalo, NY and a listed phone number of (716) 829-3332.

NPI 1619461399Buffalo, NYGeneral Practice Dentistry

Profile Overview

NPI
1619461399
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
June 18, 2018
Last Updated
January 29, 2024

Practice Location

  • 3435 Main St
  • Buffalo, NY 14214-3099

Phone: (716) 829-3332

Specialties

  • General Practice Dentistry (1223G0001X)
  • Public Health Dentistry (1223D0001X)
Full Record
NPI
1619461399
Entity Type
Individual
Last Name
Clonan
First Name
Ellyce
Credential
DDS
Mailing Street Address
3435 Main St
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14214-3099
Mailing Country
US
Mailing Phone
(716) 829-3332
Mailing Fax
(716) 833-3517
Practice Street Address
3435 Main St
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14214-3099
Practice Country
US
Practice Phone
(716) 829-3332
Practice Fax
(716) 833-3517
Enumeration Date
June 18, 2018
Last Updated
January 29, 2024
Sex
Female
Sole Proprietor
No
Certification Date
January 29, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X), Public Health Dentistry (1223D0001X)