Healthcare Provider Details

I. General information

NPI: 1376646604
Provider Name (Legal Business Name): DAVID P. DURR D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2061 RIDGE RD W
ROCHESTER NY
14626-2782
US

IV. Provider business mailing address

2061 RIDGE RD W
ROCHESTER NY
14626-2782
US

V. Phone/Fax

Practice location:
  • Phone: 585-227-4570
  • Fax: 585-227-5410
Mailing address:
  • Phone: 585-227-4570
  • Fax: 585-227-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number50 035018
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: