Provider Demographics
NPI:1083092506
Name:ALBANY FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ALBANY FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-791-8000
Mailing Address - Street 1:1819 14TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-8502
Mailing Address - Country:US
Mailing Address - Phone:541-791-8000
Mailing Address - Fax:541-928-6960
Practice Address - Street 1:1819 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-8502
Practice Address - Country:US
Practice Address - Phone:541-791-8000
Practice Address - Fax:541-928-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-16
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD4685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty