Provider Demographics
NPI:1114142858
Name:GETREU, PAUL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:GETREU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253-01 ROCKAWAY BLVD.
Mailing Address - Street 2:FIVE TOWNS SHOPPING CENTER
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-0000
Mailing Address - Country:US
Mailing Address - Phone:516-569-3524
Mailing Address - Fax:516-569-7201
Practice Address - Street 1:25301 ROCKAWAY BLVD
Practice Address - Street 2:FIVE TOWNS PLAZA
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-3113
Practice Address - Country:US
Practice Address - Phone:516-569-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist