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Organization
LAKESHORE FAMILY AND COSMETIC DENTISTRY P.C.
Active
Organization
LAKESHORE FAMILY AND COSMETIC DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRO R POPELKA DDS, MPH (PRESIDENT)
(585) 394-5800
Entity
Organization
Contact information
Practice address
3200 WEST ST, CANANDAIGUA, NY 14424-1722
(585) 394-5800
(585) 486-1284
Mailing address
3200 WEST ST, CANANDAIGUA, NY 14424-1722
(585) 394-5800
(585) 486-1284
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
50052259
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164514378
DENTIST
NY
Enumeration date
12/13/2006
Last updated
08/22/2020
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