Provider Demographics
NPI:1790815751
Name:LOVERDI, JOSEPH THOMAS (DDS PLLC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:LOVERDI
Suffix:
Gender:M
Credentials:DDS PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 AYRAULT RD
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8962
Mailing Address - Country:US
Mailing Address - Phone:585-223-4233
Mailing Address - Fax:585-223-3103
Practice Address - Street 1:815 AYRAULT RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-8962
Practice Address - Country:US
Practice Address - Phone:585-223-4233
Practice Address - Fax:585-223-3103
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04667-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice