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General NPI Number Information
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NPI Number | 1518787167
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Entity Type | Organization
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Legal Business Name | LIMA FAMILY DENTAL
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1145 BAY RD
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City | WEBSTER
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State | NY
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Zip | 14580-1834
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Country | US
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Telephone | 617-755-0603
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Fax |
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Provider Business Mailing Address
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Address Line | 3 MATTOCK PL
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City | PITTSFORD
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State | NY
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Zip | 14534-4514
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Country | US
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Telephone | 617-755-0603
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | STEFANO MOREIRA DE ARAUJO LIMA
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Credential |
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Telephone | 617-755-0603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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