Provider Demographics
NPI:1114910809
Name:ELFENBEIN, LESLIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:ELFENBEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CLIFTON AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3586
Mailing Address - Country:US
Mailing Address - Phone:973-773-6050
Mailing Address - Fax:973-773-3520
Practice Address - Street 1:1001 CLIFTON AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3586
Practice Address - Country:US
Practice Address - Phone:973-773-6050
Practice Address - Fax:973-773-3520
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ134291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics