Provider Demographics
NPI:1134390917
Name:GARDEN CITY ENDODONTICS, PLLC
Entity type:Organization
Organization Name:GARDEN CITY ENDODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BREMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-739-7668
Mailing Address - Street 1:601 FRANKLIN AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5795
Mailing Address - Country:US
Mailing Address - Phone:516-739-7668
Mailing Address - Fax:516-739-7670
Practice Address - Street 1:601 FRANKLIN AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5795
Practice Address - Country:US
Practice Address - Phone:516-739-7668
Practice Address - Fax:516-739-7670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0488511223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty