Provider Demographics
NPI:1437987658
Name:PATRICK J. RONCONE, DDS
Entity type:Organization
Organization Name:PATRICK J. RONCONE, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-889-2870
Mailing Address - Street 1:3171 CHILI AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-5440
Mailing Address - Country:US
Mailing Address - Phone:585-889-2870
Mailing Address - Fax:585-889-7978
Practice Address - Street 1:3171 CHILI AVE STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5440
Practice Address - Country:US
Practice Address - Phone:585-889-2870
Practice Address - Fax:585-889-7978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice