Provider Demographics
NPI:1366841645
Name:FINGER LAKES DENTAL CARE OF VICTOR
Entity Type:Organization
Organization Name:FINGER LAKES DENTAL CARE OF VICTOR
Other - Org Name:WENDY C MARSHALL DDS FINGER LAKES DENTAL CARE OF VICTOR
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PARISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-394-1930
Mailing Address - Street 1:7375 SR 96
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564
Mailing Address - Country:US
Mailing Address - Phone:585-869-7735
Mailing Address - Fax:
Practice Address - Street 1:7375 STATE ROUTE 96
Practice Address - Street 2:SUITE 200
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9725
Practice Address - Country:US
Practice Address - Phone:585-869-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty