Provider Demographics
NPI:1437798113
Name:ADINA FAMILY DENTAL CARE
Entity Type:Organization
Organization Name:ADINA FAMILY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JUCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-227-4900
Mailing Address - Street 1:1101 ENGLISH RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-2060
Mailing Address - Country:US
Mailing Address - Phone:585-227-4900
Mailing Address - Fax:585-225-7073
Practice Address - Street 1:1101 ENGLISH RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-2060
Practice Address - Country:US
Practice Address - Phone:585-227-4900
Practice Address - Fax:585-225-7073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty