Provider Demographics
NPI:1295886521
Name:ABBAMONTE DENTAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:ABBAMONTE DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ABBAMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-663-2130
Mailing Address - Street 1:4343 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1206
Mailing Address - Country:US
Mailing Address - Phone:585-663-2130
Mailing Address - Fax:
Practice Address - Street 1:4343 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1206
Practice Address - Country:US
Practice Address - Phone:585-663-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0500471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty