Organization
CANANDAIGUA PEDIATRIC DENTISTRY ,PC
Active
Other names
Canandaigua Pediactric Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK E WOHLFELD DDS (PRESIDENT)
(585) 394-4058
Entity
Organization
Contact information
Practice address
325 WEST ST, SUITE 101, CANANDAIGUA, NY 14424-1723
(585) 394-4058
(585) 394-4058
Mailing address
325 WEST ST, SUITE 101, CANANDAIGUA, NY 14424-1723
(585) 394-4058
(585) 394-4058
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
035232
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TF2412932
NYS TAX ID#
NY
Enumeration date
04/05/2007
Last updated
08/22/2020
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