Provider Demographics
NPI:1235169970
Name:PUTNAM, ARTHUR STANLEY (DDS)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:STANLEY
Last Name:PUTNAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ARTHUR
Other - Middle Name:STANLEY
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2440 RIDGEWAY AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4145
Mailing Address - Country:US
Mailing Address - Phone:585-295-1890
Mailing Address - Fax:585-295-1898
Practice Address - Street 1:2440 RIDGEWAY AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4145
Practice Address - Country:US
Practice Address - Phone:585-295-1890
Practice Address - Fax:585-295-1898
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047162-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice