# WESTERN NEW YORK MEDICAL PRACTICE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WESTERN NEW YORK MEDICAL PRACTICE, P.C.
- **Other names:** WNY Dental Group at Penfield
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134815301
- **Legal business name:** WESTERN NEW YORK MEDICAL PRACTICE, P.C.
- **Authorized official:** NICHOLE S HOLDER (DIRECTOR - PAYER ENROLLMENT)
- **Authorized official phone:** (585) 922-0293

## Contact information

- **Practice address:** 2226 PENFIELD RD, PENFIELD, NY 14526-1922
- **Practice address phone:** (585) 377-5810
- **Practice address fax:** (585) 377-1121
- **Mailing address:** 100 KINGS HWY S, ROCHESTER, NY 14617-5504
- **Mailing address phone:** (585) 922-1900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/12/2023
- **Last updated:** 04/12/2023