Organization
EVAN M. DENTES, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN M DENTES M.D. (OWNER)
(315) 457-7290
Entity
Organization
Contact information
Practice address
5100 W TAFT RD, SUITE 2Q, LIVERPOOL, NY 13088-3807
(315) 457-7290
(315) 451-1663
Mailing address
5100 W TAFT RD, SUITE 2Q, LIVERPOOL, NY 13088-3807
(315) 457-7290
(315) 451-1663
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
131699-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00563497
—
NY
Enumeration date
02/07/2011
Last updated
01/10/2012
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