National Provider Identifier

Susanne M Kupka-Moore, D.M.D.

Susanne M Kupka-Moore, D.M.D. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Warsaw, NY and a listed phone number of (585) 786-3676.

NPI 1477677003Warsaw, NYGeneral Practice Dentistry

Profile Overview

NPI
1477677003
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
March 19, 2007
Last Updated
July 09, 2007

Practice Location

  • 34 Duncan St
  • Warsaw, NY 14569-1017

Phone: (585) 786-3676

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1477677003
Entity Type
Individual
Last Name
Kupka-Moore
First Name
Susanne
Middle Name
M
Name Prefix
Dr.
Credential
D.M.D.
Provider Other Last Name
Kupka
Provider Other First Name
Susanne
Provider Other Middle Name
M
Provider Other Name Prefix Text
Dr.
Provider Other Credential Text
D.M.D.
Provider Other Last Name Type Code
1
Mailing Street Address
34 Duncan St
Mailing City
Warsaw
Mailing State
NY
Mailing ZIP Code
14569-1017
Mailing Country
US
Mailing Phone
(585) 786-3676
Mailing Fax
(585) 786-3896
Practice Street Address
34 Duncan St
Practice City
Warsaw
Practice State
NY
Practice ZIP Code
14569-1017
Practice Country
US
Practice Phone
(585) 786-3676
Practice Fax
(585) 786-3896
Enumeration Date
March 19, 2007
Last Updated
July 09, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)
Other Identifiers
02172916 (NY), 161350913 (NY, Federal Tax Id)