National Provider Identifier
South Coast Rochester LLC
South Coast Rochester LLC is listed in the NPPES registry with a primary specialty of Endodontics in Rochester, NY and a listed phone number of (585) 278-7199.
Profile Overview
- NPI
- 1114699303
- Provider Type
- Organization
- Primary Specialty
- Endodontics
- Enumeration Date
- October 05, 2021
- Last Updated
- October 05, 2021
Practice Location
- 840 University Ave
- Rochester, NY 14607-1288
Phone: (585) 278-7199
Mailing Address
- 58 Indiana St
- Rochester, NY 14609-7437
Specialties
- Endodontics (1223E0200X)
- Oral and Maxillofacial Surgery (Dentist) (1223S0112X)
Full Record
- NPI
- 1114699303
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- South Coast Rochester LLC
- Mailing Street Address
- 58 Indiana St
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14609-7437
- Mailing Country
- US
- Practice Street Address
- 840 University Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14607-1288
- Practice Country
- US
- Practice Phone
- (585) 278-7199
- Enumeration Date
- October 05, 2021
- Last Updated
- October 05, 2021
- Authorized Official Last Name
- Levine
- Authorized Official First Name
- George
- Authorized Official Middle Name
- Asher
- Authorized Official Title
- Owner
- Authorized Official Phone
- (585) 278-7199
- Organization Subpart
- No
- Authorized Official Credential Text
- DDS,MD
- Taxonomy Group 1
- 193200000X Multi-Specialty Group
- Taxonomy Group 2
- 193200000X Multi-Specialty Group
- Certification Date
- October 05, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Endodontics (1223E0200X), Oral and Maxillofacial Surgery (Dentist) (1223S0112X)