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General NPI Number Information
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NPI Number | 1770885824
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Entity Type | Organization
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Legal Business Name | BRUCE L. GREENBERG D.D.S., P.C.
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 18 EAST 48 STREET SUITE 1701
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-319-9777
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Fax | 212-319-9799
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Provider Business Mailing Address
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Address Line | 18 EAST 48 STREET SUITE 1701
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-319-9777
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Fax | 212-319-9799
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | BRUCE L GREENBERG
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Credential | D.D.S.
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Telephone | 212-319-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 040270
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License Number State | NY
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