Provider Demographics
NPI:1871735894
Name:SCHELLATI, NICHOLAS JOSEPH JR (MD, DDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:SCHELLATI
Suffix:JR
Gender:M
Credentials:MD, DDS
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Mailing Address - Street 1:6534 ANTHONY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1403
Mailing Address - Country:US
Mailing Address - Phone:585-924-3612
Mailing Address - Fax:
Practice Address - Street 1:6534 ANTHONY DR
Practice Address - Street 2:SUITE A
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1403
Practice Address - Country:US
Practice Address - Phone:585-924-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2012-07-25
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Provider Licenses
StateLicense IDTaxonomies
NY0527371223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery