# HARBORSIDE DENTAL TEAM AT CANANDAIGUA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harborside Dental Team at Canandaigua
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942001078
- **Authorized official:** JORDAN J ANTETOMASO DMD (OWNER)
- **Authorized official phone:** (585) 394-3736

## Contact information

- **Practice address:** 3170 WEST ST STE 250, CANANDAIGUA, NY 14424-1786
- **Practice address phone:** (585) 394-3737
- **Practice address fax:** (585) 394-3891
- **Mailing address:** 3170 WEST ST STE 250, CANANDAIGUA, NY 14424-1786
- **Mailing address phone:** (585) 208-9285
- **Mailing address fax:** (585) 208-9285

## Taxonomy

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

## Other

- **Enumeration date:** 03/24/2025
- **Last updated:** 03/31/2025