National Provider Identifier
Hometown Dental Group, PC
Hometown Dental Group, PC is listed in the NPPES registry with a primary specialty of Dentist in Rochester, NY and a listed phone number of (585) 309-1710.
Profile Overview
- NPI
- 1215080205
- Provider Type
- Organization
- Primary Specialty
- Dentist
- Enumeration Date
- January 21, 2007
- Last Updated
- September 25, 2023
Practice Location
- 34 Buckman RD
- Rochester, NY 14615-1406
Phone: (585) 309-1710
Specialties
- Dentist (122300000X)
- Dentist (122300000X)
Full Record
- NPI
- 1215080205
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Hometown Dental Group, PC
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 34 Buckman RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14615-1406
- Mailing Country
- US
- Mailing Phone
- (585) 227-4390
- Mailing Fax
- (585) 227-5215
- Practice Street Address
- 34 Buckman RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14615-1406
- Practice Country
- US
- Practice Phone
- (585) 309-1710
- Practice Fax
- (585) 227-5215
- Enumeration Date
- January 21, 2007
- Last Updated
- September 25, 2023
- Authorized Official Last Name
- Sussman
- Authorized Official First Name
- Paul
- Authorized Official Middle Name
- I
- Authorized Official Title
- Vp
- Authorized Official Phone
- (585) 227-4390
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Dr.
- Authorized Official Credential Text
- DMD
- Taxonomy Group 1
- 193400000X Multiple Single Specialty Group
- Taxonomy Group 2
- 193400000X Multiple Single Specialty Group
- Certification Date
- September 25, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X), Dentist (122300000X)