Provider Demographics
NPI:1376628644
Name:MASCIA, DARREN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:M
Last Name:MASCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 LATONA RD
Mailing Address - Street 2:BUILDING B, SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-2700
Mailing Address - Country:US
Mailing Address - Phone:585-254-4600
Mailing Address - Fax:585-458-0944
Practice Address - Street 1:550 LATONA RD
Practice Address - Street 2:BUILDING B, SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2700
Practice Address - Country:US
Practice Address - Phone:585-254-4600
Practice Address - Fax:585-458-0944
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0475751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice