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NPI 1396581682

NPI 1396581682 : MATTHEW THOMAS KAISER DDS : CANANDAIGUA, NY

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General NPI Number Information
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    NPI Number           |    1396581682
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    Entity Type          |    Individual 
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    Provider Name        |    MATTHEW THOMAS KAISER DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/05/2024
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    Last Update Date     |    12/01/2025
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Provider Practice Location Address
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    Address Line         |    329 S MAIN ST 
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    City                 |    CANANDAIGUA
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    State                |    NY
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    Zip                  |    14424-2118
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    Country              |    US
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    Telephone            |    585-394-1930
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    329 S MAIN ST 
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    City                 |    CANANDAIGUA
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    State                |    NY
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    Zip                  |    14424-2118
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    Country              |    US
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    Telephone            |    585-394-1930
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    65099
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    License Number State |    NY
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