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General NPI Number Information
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NPI Number | 1922135920
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Entity Type | Organization
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Legal Business Name | CANANDAIGUA ORAL SURGERY, PC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 500 N MAIN ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1022
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Country | US
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Telephone | 585-394-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N MAIN ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1022
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Country | US
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Telephone | 585-394-3322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILLIP GEOFFREY CARY
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Credential | DDS
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Telephone | 585-394-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 039992
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License Number State | NY
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