Basic Information
Provider Information
NPI: 1003008285
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CLAUSER
FirstName: MONIE
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1630 MAPLE RD STE 400
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142213706
CountryCode: US
TelephoneNumber: 7165682273
FaxNumber: 7165682047
Practice Location
Address1: 1630 MAPLE RD STE 400
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142213706
CountryCode: US
TelephoneNumber: 7165682273
FaxNumber: 7165682047
Other Information
ProviderEnumerationDate: 08/13/2007
LastUpdateDate: 08/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X053497NYY Dental ProvidersDentist 

No ID Information.


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