Provider Demographics
NPI:1801306469
Name:HENRIETTA FAMILY DENTAL, PLLC
Entity type:Organization
Organization Name:HENRIETTA FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:B
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:585-424-3310
Mailing Address - Street 1:2210 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4520
Mailing Address - Country:US
Mailing Address - Phone:585-424-3310
Mailing Address - Fax:585-334-6451
Practice Address - Street 1:2210 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4520
Practice Address - Country:US
Practice Address - Phone:585-424-3310
Practice Address - Fax:585-334-6451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055643261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental