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Organization
MARCELLUS FAMILY AND COSMETIC DENTISTRY, PC
Active
Organization
MARCELLUS FAMILY AND COSMETIC DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE H RAO DDS (CEO)
(315) 673-1131
Entity
Organization
Contact information
Practice address
28 E MAIN ST, MARCELLUS, NY 13108-1226
(315) 673-1131
(315) 673-2624
Mailing address
28 E MAIN ST, MARCELLUS, NY 13108-1226
(315) 673-1131
(315) 673-2624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045518-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00832669
UNITED CONCORDIA
—
05
—
02549695
—
NY
Enumeration date
09/09/2008
Last updated
09/09/2008
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