Provider Demographics
NPI:1073520797
Name:MARK J GROSS DDS & ANDREW S KAPLAN DMD PTR
Entity Type:Organization
Organization Name:MARK J GROSS DDS & ANDREW S KAPLAN DMD PTR
Other - Org Name:DENTAL PARTNERS OF FIFTH AVENE
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-987-7400
Mailing Address - Street 1:11 E 86TH ST
Mailing Address - Street 2:1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0501
Mailing Address - Country:US
Mailing Address - Phone:212-987-7400
Mailing Address - Fax:212-987-7498
Practice Address - Street 1:11 E 86TH ST
Practice Address - Street 2:1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0501
Practice Address - Country:US
Practice Address - Phone:212-987-7400
Practice Address - Fax:212-987-7498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0352771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty