Diversified Dental Service

NPI 1023102316 - Dentist - 1223G0001X

NPI Details
NPI 1023102316
Enumeration Date 10/03/2006
Last Updated 08/12/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MARK ALLEN MARK
Position DENTIST/OWNER
Phone (585) 272-0120
Fax (585) 272-0123
Practice Location
2024 W HENRIETTA RD
SUITE C
ROCHESTER NY, 14623-1355, US
Phone (585) 272-0120
Fax (585) 272-0123
Business Location
2024 W HENRIETTA RD
SUITE C
ROCHESTER NY, 14623-1355, US
Phone (585) 272-0120
Fax (585) 272-0123
Toxanomy
Taxonomy Code 1223G0001X
License State New York
License Number 041406-01
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According to our database, Diversified Dental Service NPI is 1023102316, taxonomy code is 1223G0001X and license number is 041406-01, license state is located at New York. Diversified Dental Service physically located at 2024 W Henrietta Rd, Rochester NY, 14623-1355. NPI Number 1033115704 has the healthcare provider type.

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1023102316 NPI number is provided on an as is basis without warranty of any kind. 1023102316 is maintained by the National Plan & Provider Enumeration System. The contents of Diversified Dental Service are for informational purposes only.