MEDICARE: CONTEMPORARY DENTISTRY, PLLC

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
1	122300000X	Dentist	0492701	NY
2	122300000X	Dentist	039124	NY

General Provider Information

NPI Number	:	1972666329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTEMPORARY DENTISTRY, PLLC

Provider Business Mailing Address
First Line	:	2052 CLINTON AVE S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5703
Country	:	US
Telephone Number	:	585-244-3337
Fax Number	:	575-244-0622

Provider Business Practice Location Address
First Line	:	2052 CLINTON AVE S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5703
Country	:	US
Telephone Number	:	585-244-3337
Fax Number	:	575-244-0622

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. HAROLD MESSER
Credential	:
Telephone Number	:	585-244-3337

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	08/22/2020

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