Individual
DR. MARK DAVID TENENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5713 16TH AVE, BROOKLYN, NY 11204-1811
(718) 435-1818
Mailing address
107 GOLF CT, TEANECK, NJ 07666-5635
(929) 235-1043
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
052980
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
052980
NY
Other
Enumeration date
12/14/2006
Last updated
07/21/2022
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