Individual
DR. BRUCE M EISENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
5847 FRANCIS LEWIS BLVD, SUITE 106, BAYSIDE, NY 11364-1698
(718) 428-6066
Mailing address
5847 FRANCIS LEWIS BLVD, SUITE 106, BAYSIDE, NY 11364-1698
(718) 428-6066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
32929
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32929
LICENSE #
NY
Enumeration date
03/22/2013
Last updated
03/22/2013
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