Provider Demographics
NPI:1851155451
Name:ROCHESTER DENTAL GROUP,PLLC
Entity Type:Organization
Organization Name:ROCHESTER DENTAL GROUP,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:VALERIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-729-3644
Mailing Address - Street 1:2615 CULVER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-1716
Mailing Address - Country:US
Mailing Address - Phone:585-467-2745
Mailing Address - Fax:
Practice Address - Street 1:2615 CULVER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-1716
Practice Address - Country:US
Practice Address - Phone:585-467-2745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty