Provider Demographics
NPI:1730833260
Name:DENTAL PROSTHODONTICS OF ROCHESTER PLLC
Entity type:Organization
Organization Name:DENTAL PROSTHODONTICS OF ROCHESTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:KUYUNOV
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:585-471-5689
Mailing Address - Street 1:900 WESTFALL RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2635
Mailing Address - Country:US
Mailing Address - Phone:585-471-5689
Mailing Address - Fax:
Practice Address - Street 1:900 WESTFALL RD STE A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2635
Practice Address - Country:US
Practice Address - Phone:585-471-5689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty