Provider Demographics
NPI:1174583066
Name:BECHTEL, TREVOR JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:JAMES
Last Name:BECHTEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 ERIE RD
Mailing Address - Street 2:APT. 5
Mailing Address - City:DERBY
Mailing Address - State:NY
Mailing Address - Zip Code:14047-9312
Mailing Address - Country:US
Mailing Address - Phone:716-947-4595
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:NY
Practice Address - Zip Code:14806
Practice Address - Country:US
Practice Address - Phone:607-478-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist