Individual
ANDREY USTINENKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
308 EASTERN BLVD, ASPEN DENTAL, CANANDAIGUA, NY 14424
(585) 412-5040
Mailing address
308 EASTERN BLVD, ASPEN DENTAL, CANANDAIGUA, NY 14424
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
056155
NY
Other
Enumeration date
04/06/2009
Last updated
09/19/2012
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