National Provider Identifier
Carl Louis Divita, D.D.S.
Carl Louis Divita, D.D.S. is listed in the NPPES registry with a primary specialty of Pediatric Dentistry in Spencerport, NY and a listed phone number of (585) 352-3627.
Profile Overview
- NPI
- 1710912274
- Provider Type
- Individual
- Primary Specialty
- Pediatric Dentistry
- Enumeration Date
- July 12, 2006
- Last Updated
- July 08, 2007
Practice Location
- 2800 Spencerport Road
- A4
- Spencerport, NY 14559-2180
Phone: (585) 352-3627
Mailing Address
- 2800 Spencerport RD.
- Suite A4
- Spencerport, NY 14559-2180
Specialties
- Pediatric Dentistry (1223P0221X)
Full Record
- NPI
- 1710912274
- Entity Type
- Individual
- Last Name
- Divita
- First Name
- Carl
- Middle Name
- Louis
- Name Prefix
- Dr.
- Credential
- D.D.S.
- Mailing Street Address
- 2800 Spencerport RD.
- Mailing Address Line 2
- Suite A4
- Mailing City
- Spencerport
- Mailing State
- NY
- Mailing ZIP Code
- 14559-2180
- Mailing Country
- US
- Mailing Phone
- (585) 352-3627
- Mailing Fax
- (585) 352-1678
- Practice Street Address
- 2800 Spencerport Road
- Practice Address Line 2
- A4
- Practice City
- Spencerport
- Practice State
- NY
- Practice ZIP Code
- 14559-2180
- Practice Country
- US
- Practice Phone
- (585) 352-3627
- Practice Fax
- (585) 352-1678
- Enumeration Date
- July 12, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Dentistry (1223P0221X)