Provider Demographics
NPI:1376646604
Name:DURR, DAVID P (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:DURR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 RIDGE RD W
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-2782
Mailing Address - Country:US
Mailing Address - Phone:585-227-4570
Mailing Address - Fax:585-227-5410
Practice Address - Street 1:2061 RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2782
Practice Address - Country:US
Practice Address - Phone:585-227-4570
Practice Address - Fax:585-227-5410
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50 0350181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7600OtherCHILD HEALTH PLUS
NY01157726Medicaid