Provider Demographics
NPI:1679076996
Name:OLIVER G CABRERA, DDS, PC
Entity type:Organization
Organization Name:OLIVER G CABRERA, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-621-6460
Mailing Address - Street 1:120 ERIE CANAL DR STE 150
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4600
Mailing Address - Country:US
Mailing Address - Phone:585-621-6460
Mailing Address - Fax:585-865-5227
Practice Address - Street 1:120 ERIE CANAL DR STE 150
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4600
Practice Address - Country:US
Practice Address - Phone:585-621-6460
Practice Address - Fax:585-865-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty