Healthcare Provider Details

I. General information

NPI: 1730265174
Provider Name (Legal Business Name): DEBORAH RUTH NEW D.D.S., M.S., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3171 CHILI AVE SUITE 200
ROCHESTER NY
14624-5440
US

IV. Provider business mailing address

3171 CHILI AVE SUITE 200
ROCHESTER NY
14624-5440
US

V. Phone/Fax

Practice location:
  • Phone: 585-889-8810
  • Fax: 585-889-8753
Mailing address:
  • Phone: 585-889-8810
  • Fax: 585-889-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number46437
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number19729
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: