Provider Demographics
NPI:1144238387
Name:GORKOWITZ, BERNARD DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:DAVID
Last Name:GORKOWITZ
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 1:114 W MT PLEASANT AVENUE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2932
Mailing Address - Country:US
Mailing Address - Phone:973-992-7377
Mailing Address - Fax:201-288-2384
Practice Address - Street 1:114 W MT PLEASANT AVENUE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2932
Practice Address - Country:US
Practice Address - Phone:973-992-7377
Practice Address - Fax:201-288-2384
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01726000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist