National Provider Identifier

Small Smiles Dentistry Of Rochester, LLC

Small Smiles Dentistry Of Rochester, LLC is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Rochester, NY and a listed phone number of (585) 663-1624.

NPI 1912916081Rochester, NYGeneral Practice Dentistry

Profile Overview

NPI
1912916081
Provider Type
Organization
Primary Specialty
General Practice Dentistry
Enumeration Date
August 06, 2006
Last Updated
May 17, 2010

Practice Location

  • 728 Ridge RD E
  • Rochester, NY 14621-1719

Phone: (585) 663-1624

Mailing Address

  • 201 W 8Th St
  • Suite 810
  • Pueblo, CO 81003-3038

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1912916081
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Small Smiles Dentistry Of Rochester, LLC
Mailing Street Address
201 W 8Th St
Mailing Address Line 2
Suite 810
Mailing City
Pueblo
Mailing State
CO
Mailing ZIP Code
81003-3038
Mailing Country
US
Mailing Phone
(719) 562-4447
Practice Street Address
728 Ridge RD E
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-1719
Practice Country
US
Practice Phone
(585) 663-1624
Enumeration Date
August 06, 2006
Last Updated
May 17, 2010
Authorized Official Last Name
Williams
Authorized Official First Name
Trudy
Authorized Official Title
Director, Licensing & Credentialing
Authorized Official Phone
(615) 750-0342
Organization Subpart
No
Authorized Official Name Prefix Text
MS.
Taxonomy Group 1
193400000X Single Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)
Other Identifiers
70491SS (NY, Excellus BCBS), 02617178 (NY)