Organization
MARVIN A. GERTZBERG, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN GERTZBERG DDS (OWNER)
(518) 731-2797
Entity
Organization
Contact information
Practice address
12498 US RTE 9W, WEST COXSACKIE, NY 12192
(518) 731-2797
(518) 731-9974
Mailing address
12498 STATE RTE 9W, WEST COXSACKIE, NY 12192
(518) 731-2797
(518) 731-9974
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
030835
NY
122300000X
Dentist
036653
NY
122300000X
Dentist
044897
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00471898
—
NY
05
—
00653301
—
NY
05
—
02530990
—
NY
05
—
03016671
—
NY
05
—
1538231741
—
NY
Enumeration date
06/24/2008
Last updated
07/26/2011
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