MEDICARE: ARTHUR STANLEY PUTNAM DDS

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	047162-1	NY

General Provider Information

NPI Number	:	1235169970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR STANLEY PUTNAM DDS

Provider Business Mailing Address
First Line	:	2440 RIDGEWAY AVE
Second Line	:	SUITE 230
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4145
Country	:	US
Telephone Number	:	585-295-1890
Fax Number	:	585-295-1898

Provider Business Practice Location Address
First Line	:	2440 RIDGEWAY AVE
Second Line	:	SUITE 230
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4145
Country	:	US
Telephone Number	:	585-295-1890
Fax Number	:	585-295-1898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	12/11/2007

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