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General NPI Number Information
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NPI Number | 1851599781
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Entity Type | Organization
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Legal Business Name | JOSEPH V. QUEVEDO, D.D.S., P.C.
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2425 CLOVER ST
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City | ROCHESTER
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State | NY
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Zip | 14618-4517
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Country | US
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Telephone | 585-256-2200
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Fax | 585-256-0443
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Provider Business Mailing Address
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Address Line | 2425 CLOVER ST
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City | ROCHESTER
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State | NY
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Zip | 14618-4517
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Country | US
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Telephone | 585-256-2200
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Fax | 585-256-0443
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH VINCENT QUEVEDO
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Credential | D.D.S., P.C.
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Telephone | 585-256-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 047178-1
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License Number State | NY
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