National Provider Identifier
Demetrios Louis Consolo
Demetrios Louis Consolo is listed in the NPPES registry with a primary specialty of Dental Assistant in Canandaigua, NY and a listed phone number of (585) 393-7172.
Profile Overview
- NPI
- 1780874016
- Provider Type
- Individual
- Primary Specialty
- Dental Assistant
- Enumeration Date
- August 01, 2007
- Last Updated
- August 01, 2007
Practice Location
- 400 Fort Hill Ave
- Dental Dept
- Canandaigua, NY 14424-1159
Phone: (585) 393-7172
Mailing Address
- 1720 Waterford RD
- Walworth, NY 14568-9424
Specialties
- Dental Assistant (126800000X)
Full Record
- NPI
- 1780874016
- Entity Type
- Individual
- Last Name
- Consolo
- First Name
- Demetrios
- Middle Name
- Louis
- Name Prefix
- Mr.
- Mailing Street Address
- 1720 Waterford RD
- Mailing City
- Walworth
- Mailing State
- NY
- Mailing ZIP Code
- 14568-9424
- Mailing Country
- US
- Mailing Phone
- (909) 434-5129
- Practice Street Address
- 400 Fort Hill Ave
- Practice Address Line 2
- Dental Dept
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-1159
- Practice Country
- US
- Practice Phone
- (585) 393-7172
- Enumeration Date
- August 01, 2007
- Last Updated
- August 01, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dental Assistant (126800000X)