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Organization
MARY ANN PANARA DDS AND JEFFREY P PANARA DDS
Active
Organization
MARY ANN PANARA DDS AND JEFFREY P PANARA DDS
Active
Other names
Fairport Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MARRY ANN PANARA DDS (OWNER/DENTIST)
(585) 223-9323
Entity
Organization
Contact information
Practice address
83 S MAIN ST, FAIRPORT, NY 14450-2161
(585) 223-9323
(585) 223-0702
Mailing address
83 S MAIN ST, FAIRPORT, NY 14450-2161
(585) 223-9323
(585) 223-0702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
043442
NY
1223G0001X
General Practice Dentistry
044604
NY
332BC3200X
Customized Equipment (DME)
043442
NY
332BC3200X
Customized Equipment (DME)
044604
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7040
EXCELLUS
NY
01
—
7239
EXCELLUS
NY
Enumeration date
06/02/2017
Last updated
07/21/2022
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