| Canandaigua Pediatric Dentistry ,pc | |
|
325 West St Suite 101 Canandaigua NY 14424-1723 | |
| (585) 394-4058 | |
| (585) 394-4058 |
| Full Name | Canandaigua Pediatric Dentistry ,pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 325 West St, Canandaigua, New York |
| Authorized Official Name and Position | Mark E Wohlfeld (PRESIDENT) |
| Authorized Official Contact | 5853944058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canandaigua Pediatric Dentistry ,pc 325 West St Suite 101 Canandaigua NY 14424-1723 Ph: (585) 394-4058 | Canandaigua Pediatric Dentistry ,pc 325 West St Suite 101 Canandaigua NY 14424-1723 Ph: (585) 394-4058 |
| NPI Number | 1427170844 |
|---|---|
| Provider Enumeration Date | 04/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427170844 | NPI | - | NPPES |
| TF2412932 | Other | NY | NYS TAX ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 035232 (New York) | Primary |
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