Provider Demographics
NPI:1215045620
Name:ROBERT J CLEARY DDS PC
Entity Type:Organization
Organization Name:ROBERT J CLEARY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-624-2910
Mailing Address - Street 1:67 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-1130
Mailing Address - Country:US
Mailing Address - Phone:585-624-2910
Mailing Address - Fax:585-624-8354
Practice Address - Street 1:67 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-1130
Practice Address - Country:US
Practice Address - Phone:585-624-2910
Practice Address - Fax:585-624-8354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0350481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty