Provider Demographics
NPI:1417008897
Name:PROGRESSIVE ENDODONTICS LLC
Entity Type:Organization
Organization Name:PROGRESSIVE ENDODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARINDERBIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:585-256-1500
Mailing Address - Street 1:980 WESTFALL RD
Mailing Address - Street 2:SUITE 210, BUILDING 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2605
Mailing Address - Country:US
Mailing Address - Phone:585-256-1500
Mailing Address - Fax:
Practice Address - Street 1:980 WESTFALL RD
Practice Address - Street 2:SUITE 210, BUILDING 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2605
Practice Address - Country:US
Practice Address - Phone:585-256-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050621-11223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty