Provider Demographics
NPI:1063946952
Name:ALBEE FAMILY DENTAL
Entity type:Organization
Organization Name:ALBEE FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:ALBEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-225-8010
Mailing Address - Street 1:1081 LONG POND RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-5002
Mailing Address - Country:US
Mailing Address - Phone:585-225-8010
Mailing Address - Fax:585-621-5534
Practice Address - Street 1:1081 LONG POND RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-5002
Practice Address - Country:US
Practice Address - Phone:585-225-8010
Practice Address - Fax:585-621-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043311122300000X
NY049076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty