National Provider Identifier
Kidane Michael Tewolde
Kidane Michael Tewolde is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Buffalo, NY and a listed phone number of (716) 898-1736.
Profile Overview
- NPI
- 1811525827
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- March 27, 2020
- Last Updated
- September 19, 2023
Practice Location
- 462 Grider St
- Buffalo, NY 14215-3021
Phone: (716) 898-1736
Mailing Address
- 6 Walling Ave
- Oneonta, NY 13820-1916
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1811525827
- Entity Type
- Individual
- Last Name
- Tewolde
- First Name
- Kidane
- Middle Name
- Michael
- Name Prefix
- Dr.
- Mailing Street Address
- 6 Walling Ave
- Mailing City
- Oneonta
- Mailing State
- NY
- Mailing ZIP Code
- 13820-1916
- Mailing Country
- US
- Mailing Phone
- (607) 437-1041
- Practice Street Address
- 462 Grider St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-3021
- Practice Country
- US
- Practice Phone
- (716) 898-1736
- Enumeration Date
- March 27, 2020
- Last Updated
- September 19, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 19, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)