Provider Demographics
NPI:1124365564
Name:SYLOR, PEGGI M (RDH)
Entity Type:Individual
Prefix:
First Name:PEGGI
Middle Name:M
Last Name:SYLOR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5695 W LAKE RD
Mailing Address - Street 2:APT. 2
Mailing Address - City:CONESUS
Mailing Address - State:NY
Mailing Address - Zip Code:14435-9322
Mailing Address - Country:US
Mailing Address - Phone:585-489-5489
Mailing Address - Fax:
Practice Address - Street 1:1 MURRAY HILL DR
Practice Address - Street 2:BLD.1
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1153
Practice Address - Country:US
Practice Address - Phone:585-243-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025001-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist