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General NPI Number Information
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NPI Number | 1881146785
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Entity Type | Organization
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Legal Business Name | DD PITCHER LLC
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 30 OFFICE PARK WAY
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City | PITTSFORD
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State | NY
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Zip | 14534-1734
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Country | US
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Telephone | 585-586-9063
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Fax | 585-586-1478
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Provider Business Mailing Address
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Address Line | 30 OFFICE PARK WAY
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City | PITTSFORD
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State | NY
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Zip | 14534-1734
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Country | US
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Telephone | 585-586-9063
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Fax | 585-586-1478
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DONALD PITCHER
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Credential | D.D.S.
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Telephone | 585-586-9063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 058771
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License Number State | NY
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