Organization
AZITA ANISSI DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZITA ANISSI DDS (DENTIST)
(585) 267-7745
Entity
Organization
Contact information
Practice address
121 SULLYS TRAIL SUITE 1, PITTSFORD, NY 14534
(585) 267-7745
(585) 267-7748
Mailing address
121 SULLYS TRAIL SUITE 1, PITTSFORD, NY 14534
(585) 267-7745
(585) 267-7748
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01343544
—
NY
Enumeration date
12/11/2018
Last updated
12/11/2018
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