Organization
CYNTHIA K SLACK DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA K SLACK DDS (PRESIDENT)
(585) 426-2550
Entity
Organization
Contact information
Practice address
523 BEAHAN RD, WESTGATE WOOD PROFESSIONAL COMPLEX, ROCHESTER, NY 14624-3403
(585) 426-2550
(585) 426-4118
Mailing address
523 BEAHAN RD, WESTGATE WOOD PROFESSIONAL COMPLEX, ROCHESTER, NY 14624-3403
(585) 426-2550
(585) 426-4118
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
035772
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144266222
—
NY
Enumeration date
09/15/2010
Last updated
09/15/2010
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