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Individual

ANTHONY J MENDICINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
6692 MIDDLE RD, SUITE 2100, SODUS, NY 14551-9602
(315) 483-1199
(315) 483-2451
Mailing address
PO BOX 423, PENN YAN, NY 14527-0423
(315) 531-9102
(315) 531-9103

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42164
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02562825
NY
01
70461FL
EXCELLUS SODUS SITE
NY
01
70503GH
EXCELLUS GENEVA SITE
NY
Enumeration date
09/25/2006
Last updated
02/16/2017
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