Provider Demographics
NPI:1881146785
Name:DD PITCHER LLC
Entity type:Organization
Organization Name:DD PITCHER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:PITCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-586-9063
Mailing Address - Street 1:30 OFFICE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1734
Mailing Address - Country:US
Mailing Address - Phone:585-586-9063
Mailing Address - Fax:585-586-1478
Practice Address - Street 1:30 OFFICE PARK WAY
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1734
Practice Address - Country:US
Practice Address - Phone:585-586-9063
Practice Address - Fax:585-586-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058771261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery