Healthcare Provider Details

I. General information

NPI: 1699785634
Provider Name (Legal Business Name): ROCHESTER ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 12/12/2019
Certification Date: 12/12/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 PITTSFORD PALMYRA RD SUITE 110
FAIRPORT NY
14450-3584
US

IV. Provider business mailing address

6800 PITTSFORD PALMYRA RD SUITE 110
FAIRPORT NY
14450-3584
US

V. Phone/Fax

Practice location:
  • Phone: 585-223-5330
  • Fax: 585-223-7601
Mailing address:
  • Phone: 585-223-5330
  • Fax: 585-223-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLE J SAISSELIN
Title or Position: OWNER
Credential: DDS
Phone: 585-223-5330