MEDICARE: FINGER LAKES DENTAL CARE, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1104090513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FINGER LAKES DENTAL CARE, PC

Provider Business Mailing Address
First Line	:	329 S MAIN ST
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-2118
Country	:	US
Telephone Number	:	585-394-1930
Fax Number	:	585-394-1938

Provider Business Practice Location Address
First Line	:	329 SOUTH MAIN STREET
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424
Country	:	US
Telephone Number	:	585-394-1930
Fax Number	:	585-394-1938

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	JENNIFER A MORELLO
Credential	:
Telephone Number	:	585-919-6624

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	12/12/2025

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