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1510 Ridge Rd W Rochester NY 14615-2405 | |
| (585) 865-2200 | |
| (585) 865-6693 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1510 Ridge Rd W, Rochester, New York |
| Authorized Official Name and Position | Steven Braunstein (PC ASSISTANT SECRETARY) |
| Authorized Official Contact | 7166344679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1510 Ridge Rd W Rochester NY 14615-2405 Ph: (585) 865-2200 | 1510 Ridge Rd W Rochester NY 14615-2405 Ph: (585) 865-2200 |
| NPI Number | 1619039773 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619039773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 032062 (New York) | Primary |
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