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General NPI Number Information
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NPI Number | 1699807362
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Entity Type | Organization
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Legal Business Name | SIA N. HERSINI, DMD, PC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 404 WILLIAM ST SUITE D
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City | GENEVA
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State | NY
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Zip | 14456-2143
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Country | US
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Telephone | 315-789-9054
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Fax | 315-781-1297
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Provider Business Mailing Address
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Address Line | 404 WILLIAM ST SUITE D
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City | GENEVA
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State | NY
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Zip | 14456-2143
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Country | US
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Telephone | 315-789-9054
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Fax | 315-781-1297
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Authorized Official
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Title or Position | CEO
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Name | SIA N HERSINI
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Credential | DMD
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Telephone | 315-789-9054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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