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General NPI Number Information
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NPI Number | 1134390917
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Entity Type | Organization
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Legal Business Name | GARDEN CITY ENDODONTICS, PLLC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 601 FRANKLIN AVE SUITE 210
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City | GARDEN CITY
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State | NY
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Zip | 11530-5795
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Country | US
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Telephone | 516-739-7668
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Fax | 516-739-7670
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Provider Business Mailing Address
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Address Line | 601 FRANKLIN AVE SUITE 210
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City | GARDEN CITY
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State | NY
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Zip | 11530-5795
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Country | US
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Telephone | 516-739-7668
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Fax | 516-739-7670
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC WILLIAM BREMER
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Credential | DDS
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Telephone | 516-739-7668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 048851
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License Number State | NY
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