# GRASSI DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457094773
- **Authorized official:** NICOLE GRASSI DDS (OWNER)
- **Authorized official phone:** (315) 729-6206

## Contact information

- **Practice address:** 6789 E GENESEE ST \# 1B, FAYETTEVILLE, NY 13066-1640
- **Practice address phone:** (315) 729-6206
- **Mailing address:** 1103 SIDNEY ST, SYRACUSE, NY 13219-1719
- **Mailing address phone:** (315) 729-6206

## Taxonomy

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

## Other

- **Enumeration date:** 04/14/2022
- **Last updated:** 04/30/2024