Individual
SHYLON T MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1510 RIDGE RD W, ROCHESTER, NY 14615-2405
(585) 865-6691
Mailing address
18 HIGH MANOR DR, APT. 1, HENRIETTA, NY 14467-9109
(973) 615-5113
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
053101
NY
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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