Provider Demographics
NPI:1710950605
Name:ODDO, ROCCO JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROCCO
Middle Name:JOSEPH
Last Name:ODDO
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 1:225 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3437
Mailing Address - Country:US
Mailing Address - Phone:716-633-8108
Mailing Address - Fax:
Practice Address - Street 1:2887 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1326
Practice Address - Country:US
Practice Address - Phone:716-877-2275
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0475221223D0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223D0001XDental ProvidersDentistDental Public Health
Not Answered1223G0001XDental ProvidersDentistGeneral Practice