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NPI Code Detail

MEDICARE: DR. CHARLES M. OSTER D.D.S.

MEDICARE: DR. CHARLES M. OSTER D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0700XProsthodontics034283NY

General Provider Information

NPI Number : 1104853886
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES M. OSTER D.D.S.
Provider Business Mailing Address
First Line : 61 BONITA DR
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-1013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 625 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-2913
Country : US
Telephone Number : 585-275-1129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 07/08/2007

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