National Provider Identifier
Peter John Demarco Jr., DDS
Peter John Demarco Jr., DDS is listed in the NPPES registry with a primary specialty of Dentist in Eden, NY and a listed phone number of (716) 575-4108.
Profile Overview
- NPI
- 1922095355
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- September 30, 2005
- Last Updated
- May 28, 2014
Practice Location
- 3122 Kulp RD.
- Eden, NY 14057
Phone: (716) 575-4108
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1922095355
- Entity Type
- Individual
- Last Name
- Demarco
- First Name
- Peter
- Middle Name
- John
- Name Prefix
- Dr.
- Name Suffix
- Jr.
- Credential
- DDS
- Mailing Street Address
- 3122 Kulp RD.
- Mailing City
- Eden
- Mailing State
- NY
- Mailing ZIP Code
- 14057
- Mailing Country
- US
- Mailing Phone
- (716) 575-4108
- Practice Street Address
- 3122 Kulp RD.
- Practice City
- Eden
- Practice State
- NY
- Practice ZIP Code
- 14057
- Practice Country
- US
- Practice Phone
- (716) 575-4108
- Enumeration Date
- September 30, 2005
- Last Updated
- May 28, 2014
- Deactivation Date
- May 14, 2014
- Reactivation Date
- May 28, 2014
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)
- Other Identifiers
- 01095514 (NY)