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General NPI Number Information
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NPI Number | 1295496933
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Entity Type | Organization
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Legal Business Name | TC GREECE PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 2081 W RIDGE RD STE 107
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City | GREECE
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State | NY
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Zip | 14626-2724
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Country | US
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Telephone | 585-227-4570
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Fax | 585-227-5410
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Provider Business Mailing Address
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Address Line | 2081 W RIDGE RD STE 107
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City | GREECE
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State | NY
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Zip | 14626-2724
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Country | US
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Telephone | 585-227-4570
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Fax | 585-227-5410
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ABRAHIM CAROCI
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Credential | DMD
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Telephone | 585-775-5052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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