Provider Demographics
NPI:1154453629
Name:CASSATA, SUZANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:CASSATA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RIDGE RD W
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-3030
Mailing Address - Country:US
Mailing Address - Phone:585-254-1650
Mailing Address - Fax:585-254-1653
Practice Address - Street 1:1 RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-3030
Practice Address - Country:US
Practice Address - Phone:585-254-1650
Practice Address - Fax:585-254-1653
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0416561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics