Provider Demographics
NPI:1497897094
Name:SPOTO, JOHN MYRON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MYRON
Last Name:SPOTO
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 1:2005 LYELL AVE SUITE 220
Mailing Address - Street 2:SPOTO FAMILY DENTAL
Mailing Address - City:ROCH
Mailing Address - State:NY
Mailing Address - Zip Code:14606-2399
Mailing Address - Country:US
Mailing Address - Phone:585-254-4414
Mailing Address - Fax:585-254-4474
Practice Address - Street 1:2005 LYELL AVE SUITE 220
Practice Address - Street 2:SPOTO FAMILY DENTAL
Practice Address - City:ROCH
Practice Address - State:NY
Practice Address - Zip Code:14606-2399
Practice Address - Country:US
Practice Address - Phone:585-254-4414
Practice Address - Fax:585-254-4474
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0434951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice