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General NPI Number Information
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NPI Number | 1437358132
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Entity Type | Organization
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Legal Business Name | ONTARIO ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 90 N MAIN ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1232
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Country | US
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Telephone | 585-394-2830
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Fax | 585-394-4244
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Provider Business Mailing Address
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Address Line | 90 N MAIN ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1232
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Country | US
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Telephone | 585-394-2830
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Fax | 585-394-4244
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN RHEUDE
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Credential |
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Telephone | 585-394-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 049589-1
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License Number State | NY
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