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General NPI Number Information
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NPI Number | 1750048948
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Entity Type | Organization
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Legal Business Name | PITTSFORD SMILES DENTAL, PC
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 55 SULLYS TRL STE B
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City | PITTSFORD
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State | NY
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Zip | 14534-3701
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Country | US
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Telephone | 585-820-1250
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Fax |
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Provider Business Mailing Address
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Address Line | 3349 MONROE AVE STE 334
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City | ROCHESTER
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State | NY
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Zip | 14618-5513
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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 | RICARDO HUERTA-ANDRADE
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Credential | DDS
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Telephone | 585-820-1250
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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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