Healthcare Provider Details

I. General information

NPI: 1952433427
Provider Name (Legal Business Name): SUZANNE CASSATA D.D.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIDGE RD W
ROCHESTER NY
14615-3030
US

IV. Provider business mailing address

62 HUNTING SPG
ROCHESTER NY
14624-4357
US

V. Phone/Fax

Practice location:
  • Phone: 585-254-1650
  • Fax: 585-254-1653
Mailing address:
  • Phone: 585-889-5283
  • Fax: 585-889-5159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number041656
License Number StateNY

VIII. Authorized Official

Name: DR. SUZANNE CASSATA
Title or Position: CEO
Credential: D.D.S.
Phone: 585-254-1650