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NPI Code Detail

MEDICARE: LENNY SANTOS DDS

MEDICARE: LENNY SANTOS 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
1122300000XDentist059601-1NY

General Provider Information

NPI Number : 1811384191
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENNY SANTOS DDS
Provider Business Mailing Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2320
Fax Number :
Provider Business Practice Location Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-487-8613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2015
Last Update Date : 09/21/2018

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