Provider Demographics
NPI:1396809570
Name:ATTARDI, DAVID MARK (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:ATTARDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 TITUS AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622-2231
Mailing Address - Country:US
Mailing Address - Phone:585-467-6040
Mailing Address - Fax:
Practice Address - Street 1:1338 RIDGE RD E
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2018
Practice Address - Country:US
Practice Address - Phone:585-544-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05097311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice