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General NPI Number Information
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NPI Number | 1366886632
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Entity Type | Organization
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Legal Business Name | LALOR FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 1216 UPPER FRONT STREET
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City | BINGHAMTON
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State | NY
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Zip | 13905
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Country | US
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Telephone | 607-217-5581
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 UPPER FRONT STREET
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City | BINGHAMTON
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State | NY
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Zip | 13905
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Country | US
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Telephone | 607-217-5581
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | MR. ROBERT ANDREW LALOR
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Credential | DDS
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Telephone | 607-258-0039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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