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General NPI Number Information
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NPI Number | 1982825691
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Entity Type | Individual
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Provider Name | JUDD GARSON SR. DDS
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4405 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10040-4014
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Country | US
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Telephone | 212-568-1500
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Fax | 212-740-2097
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Provider Business Mailing Address
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Address Line | 16 BELAIRE CT
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-3035
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Country | US
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Telephone | 732-607-2223
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Fax | 732-607-2223
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 035589
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License Number State | NY
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