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NPI Code Detail

MEDICARE: RICHARD W. MAINS,JR.,D.M.D., PC

MEDICARE: RICHARD W. MAINS,JR.,D.M.D., PC
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 Dentistry29844NY

General Provider Information

NPI Number : 1922196245
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD W. MAINS,JR.,D.M.D., PC
Provider Business Mailing Address
First Line : 625 PANORAMA TRL
Second Line : BLDG 2, SUITE 200
City : ROCHESTER
State : NY
Zip : 14625-2404
Country : US
Telephone Number : 585-586-6670
Fax Number : 585-586-6701
Provider Business Practice Location Address
First Line : 625 PANORAMA TRL
Second Line : BLDG 2, SUITE 200
City : ROCHESTER
State : NY
Zip : 14625-2404
Country : US
Telephone Number : 585-586-6670
Fax Number : 585-586-6701
Authorized Official
Title or Position : PRESIDENT/DENTIST
Name : DR. RICHARD WESLEY MAINS JR.
Credential : DMD
Telephone Number : 585-586-6670
Provider Enumeration Date : 10/11/2006
Last Update Date : 08/22/2020

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