| NPI | 1770011728 |
|---|---|
| Doing Business As | FAIRPORT FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARRY ANN PANARA Owner/Dentist 585-223-9323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 043442) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 044604) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NY 044604) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NY 043442) | |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2022-07-21 |