Provider Demographics
NPI:1821106436
Name:HUERTA-ANDRADE, RICARDO (DDS)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:HUERTA-ANDRADE
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 1:3349 MONROE AVE STE 334
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5513
Mailing Address - Country:US
Mailing Address - Phone:585-820-1250
Mailing Address - Fax:
Practice Address - Street 1:7181 STATE ROUTE 96
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-8989
Practice Address - Country:US
Practice Address - Phone:585-924-4050
Practice Address - Fax:585-924-4905
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0522711223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics