National Provider Identifier

East Avenue Dentistry PLLC

East Avenue Dentistry PLLC is listed in the NPPES registry with a primary specialty of Dental Clinic/Center in Rochester, NY and a listed phone number of (585) 482-5504.

NPI 1669649166Rochester, NYDental Clinic/Center

Profile Overview

NPI
1669649166
Provider Type
Organization
Primary Specialty
Dental Clinic/Center
Enumeration Date
May 13, 2008
Last Updated
May 13, 2008

Practice Location

  • 1641 East Ave
  • Rochester, NY 14610-1616

Phone: (585) 482-5504

Specialties

  • Dental Clinic/Center (261QD0000X)
Full Record
NPI
1669649166
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
East Avenue Dentistry PLLC
Mailing Street Address
1641 East Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14610-1616
Mailing Country
US
Mailing Phone
(585) 482-5504
Mailing Fax
(585) 482-5507
Practice Street Address
1641 East Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14610-1616
Practice Country
US
Practice Phone
(585) 482-5504
Practice Fax
(585) 482-5507
Enumeration Date
May 13, 2008
Last Updated
May 13, 2008
Authorized Official Last Name
Rosen
Authorized Official First Name
Harry
Authorized Official Middle Name
Norman
Authorized Official Title
Member
Authorized Official Phone
(585) 586-5480
Organization Subpart
No
Authorized Official Name Prefix Text
Dr.
Authorized Official Credential Text
D.D.S.
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Dental Clinic/Center (261QD0000X)