Western New York Dental Group,pc
Dentist, General Practice in Rochester, NY. Organization (NPI-2).
NPI number1619039773
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1619039773
- Entity type
- Organization (NPI-2)
- Legal business name
- Western New York Dental Group,pc
- Organization subpart
- No
- Enumeration date
- Dec 15, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 032062 | NY | Yes |
Other names
- Dental Associates Of Rochester (Former Legal Business Name)
Practice location
1510 Ridge Rd WRochester, NY 14615-2405
Phone 585-865-2200 · Fax 585-865-6693
Mailing address
1510 Ridge Rd WRochester, NY 14615-2405
Phone 585-865-2200 · Fax 585-865-6693
Authorized official
Steven Braunstein
PC Assistant Secretary
7166344679
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