Provider Demographics
NPI:1699255307
Name:URGENT DENTAL CARE, PLLC
Entity type:Organization
Organization Name:URGENT DENTAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:SANSONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-729-7777
Mailing Address - Street 1:4343 DEWEY AVE UPPR SUITE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1206
Mailing Address - Country:US
Mailing Address - Phone:585-729-7777
Mailing Address - Fax:585-621-3637
Practice Address - Street 1:1740 CULVER RD LOWR SUITE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-3836
Practice Address - Country:US
Practice Address - Phone:585-729-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0463311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty