Organization
FANTUZZO ORAL, MAXILLOFACIAL, AND DENTAL IMPLANT SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH J FANTUZZO DDS AND MD (OWNER/PROVIDER)
(585) 203-1524
Entity
Organization
Contact information
Practice address
77 MAHOGANY RUN, PITTSFORD, NY 14534-9424
(585) 203-1524
Mailing address
1815 CLINTON AVE. SOUTH SUITE 320, ROCHESTER, NY 14618
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
048604
NY
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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