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NPI Code Detail

MEDICARE: JENNIFER J CALNON DDS

MEDICARE: JENNIFER J CALNON DDS
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
11223G0001XGeneral Practice Dentistry054454NY

General Provider Information

NPI Number : 1558533604
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER J CALNON DDS
Provider Business Mailing Address
First Line : 2615 CULVER RD
Second Line : SUITE 200
City : ROCHESTER
State : NY
Zip : 14609-1716
Country : US
Telephone Number : 585-467-2745
Fax Number : 585-467-5683
Provider Business Practice Location Address
First Line : 2615 CULVER RD
Second Line : SUITE 200
City : ROCHESTER
State : NY
Zip : 14609-1716
Country : US
Telephone Number : 585-467-2745
Fax Number : 585-467-5683
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2008
Last Update Date : 03/05/2012

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