# PETER GENCO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Peter Genco
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942703251
- **Authorized official:** DR. PETER A GENCO DOCTOR (DMD)
- **Authorized official phone:** (845) 434-1202

## Contact information

- **Practice address:** 5203 MAIN ST, SOUTH FALLSBURG, NY 12779-5422
- **Practice address phone:** (845) 434-1202
- **Mailing address:** 5203 MAIN ST, SOUTH FALLSBURG, NY 12779-5422
- **Mailing address phone:** (845) 434-1202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 049937-1 | NY | Yes |

## Other

- **Enumeration date:** 03/13/2018
- **Last updated:** 03/13/2018