Individual
DR. CARL LOUIS DIVITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2800 SPENCERPORT ROAD, A4, SPENCERPORT, NY 14559-2180
(585) 352-3627
(585) 352-1678
Mailing address
2800 SPENCERPORT RD., SUITE A4, SPENCERPORT, NY 14559-2180
(585) 352-3627
(585) 352-1678
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
027463-1
NY
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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