Provider Demographics
NPI:1710544838
Name:ANTONIO CALASCIBETTA, DDS, PLLC
Entity Type:Organization
Organization Name:ANTONIO CALASCIBETTA, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CALASCIBETTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-355-2141
Mailing Address - Street 1:4178 W HENRIETTA RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5224
Mailing Address - Country:US
Mailing Address - Phone:585-355-2141
Mailing Address - Fax:
Practice Address - Street 1:4178 W HENRIETTA RD STE B
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5224
Practice Address - Country:US
Practice Address - Phone:585-355-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTONIO CALASCIBETTA, DDS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies