Healthcare Provider Details

I. General information

NPI: 1306904248
Provider Name (Legal Business Name): CLAUDIA LAMBERTUCCI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MT READ BLVD 159 WEST MAIN ST
ROCHESTER NY
14616
US

IV. Provider business mailing address

3000 MT READ BLVD
ROCHESTER NY
14616
US

V. Phone/Fax

Practice location:
  • Phone: 585-663-1300
  • Fax:
Mailing address:
  • Phone: 585-663-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0490491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: