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General NPI Number Information
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NPI Number | 1457774424
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Entity Type | Individual
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Provider Name | JOSHUA STEVEN BRONNER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 75 WEIBEL AVE
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City | SARATOGA
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State | NY
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Zip | 12866-5328
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Country | US
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Telephone | 518-633-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 570 ALBEMARLE PL
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City | CEDARHURST
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State | NY
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Zip | 11516-1004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 058098
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License Number State | NY
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