Provider Demographics
NPI:1952433427
Name:SUZANNE CASSATA D.D.S.
Entity Type:Organization
Organization Name:SUZANNE CASSATA D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSATA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-254-1650
Mailing Address - Street 1:62 HUNTING SPG
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-4357
Mailing Address - Country:US
Mailing Address - Phone:585-889-5283
Mailing Address - Fax:585-889-5159
Practice Address - Street 1:1 RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-3030
Practice Address - Country:US
Practice Address - Phone:585-254-1650
Practice Address - Fax:585-254-1653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0416561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty