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General NPI Number Information
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NPI Number | 1629331228
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Entity Type | Organization
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Legal Business Name | CALM DENTAL PC
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 109 MAIN ST
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City | GENESEO
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State | NY
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Zip | 14454
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Country | US
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Telephone | 585-447-9222
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Fax | 585-486-3946
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Provider Business Mailing Address
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Address Line | 3200 WEST STREET
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City | CANANDAIGUA
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State | NY
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Zip | 14424
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SANDRO ROBERTO POPELKA
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Credential | DDS, MPH
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Telephone | 585-394-5800
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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 | 50-052259
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License Number State | NY
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