Provider Demographics
NPI:1518787167
Name:LIMA FAMILY DENTAL
Entity type:Organization
Organization Name:LIMA FAMILY DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:STEFANO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREIRA DE ARAUJO LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-755-0603
Mailing Address - Street 1:3 MATTOCK PL
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4514
Mailing Address - Country:US
Mailing Address - Phone:617-755-0603
Mailing Address - Fax:
Practice Address - Street 1:1145 BAY RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1834
Practice Address - Country:US
Practice Address - Phone:617-755-0603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental