Provider Demographics
NPI:1972626745
Name:KAUFER, VIRGINIA FUSARO (DMD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:FUSARO
Last Name:KAUFER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:FUSARO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:34 SUTHERLAND ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1933
Mailing Address - Country:US
Mailing Address - Phone:585-385-4163
Mailing Address - Fax:
Practice Address - Street 1:10 ASSEMBLY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MENDON
Practice Address - State:NY
Practice Address - Zip Code:14506-0455
Practice Address - Country:US
Practice Address - Phone:585-624-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0362491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice