Provider Demographics
NPI:1013256114
Name:FAMILY DENTISTRY LLP
Entity Type:Organization
Organization Name:FAMILY DENTISTRY LLP
Other - Org Name:CONTEMPORARY DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DELLE DONNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-878-4488
Mailing Address - Street 1:110 MONTAUK HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955
Mailing Address - Country:US
Mailing Address - Phone:631-878-4488
Mailing Address - Fax:631-878-7330
Practice Address - Street 1:110 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11955-1407
Practice Address - Country:US
Practice Address - Phone:631-878-4488
Practice Address - Fax:631-878-7330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35987122300000X
NY40449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty