Healthcare Provider Details

I. General information

NPI: 1235169970
Provider Name (Legal Business Name): ARTHUR STANLEY PUTNAM DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ARTHUR STANLEY BURNS DDS

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 RIDGEWAY AVE SUITE 230
ROCHESTER NY
14626-4145
US

IV. Provider business mailing address

2440 RIDGEWAY AVE SUITE 230
ROCHESTER NY
14626-4145
US

V. Phone/Fax

Practice location:
  • Phone: 585-295-1890
  • Fax: 585-295-1898
Mailing address:
  • Phone: 585-295-1890
  • Fax: 585-295-1898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number047162-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: