Provider Demographics
NPI:1528683018
Name:AMORIM DA SILVA GUSMINI, MONICA (DDS)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:AMORIM DA SILVA GUSMINI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:AMORIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:10 HELMSFORD WAY
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1910
Mailing Address - Country:US
Mailing Address - Phone:585-690-6128
Mailing Address - Fax:
Practice Address - Street 1:329 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-2118
Practice Address - Country:US
Practice Address - Phone:585-919-6624
Practice Address - Fax:585-394-1938
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0617361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program