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General NPI Number Information
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NPI Number | 1790834349
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Entity Type | Individual
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Provider Name | MORTON CARL RENNERT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 30 E 60TH ST ROOM 302
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City | NEW YORK
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State | NY
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Zip | 10022-1008
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Country | US
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Telephone | 212-355-5640
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Fax | 212-355-5209
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Provider Business Mailing Address
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Address Line | 300 WINSTON DR APT. 2215
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-3236
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Country | US
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Telephone | 201-886-9448
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 022015
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License Number State | NY
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