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Organization
UNIVERSITY OF ROCHESTER
Active
Organization
UNIVERSITY OF ROCHESTER
Active
Parent organization
UNIVERSITY OF ROCHESTER
Other names
Eastman Dental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF ROCHESTER
Authorized official
ADAM ANOLIK (CFO)
(585) 275-3300
Entity
Organization
Contact information
Practice address
625 ELMWOOD AVE, BOX 683, ROCHESTER, NY 14620-2913
(585) 275-5022
(585) 276-0293
Mailing address
625 ELMWOOD AVE, BOX 683, ROCHESTER, NY 14620-2913
(585) 275-5022
(585) 276-0293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355239
—
NY
01
—
7165
BLUE SHIELD
NY
Enumeration date
10/24/2006
Last updated
07/14/2020
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