Provider Demographics
NPI:1205022829
Name:GANZ & GROSSMAN, DDS, PC.
Entity Type:Organization
Organization Name:GANZ & GROSSMAN, DDS, PC.
Other - Org Name:CENTER FOR ADVANCED DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-683-0888
Mailing Address - Street 1:1600 STEWART AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6696
Mailing Address - Country:US
Mailing Address - Phone:516-683-0888
Mailing Address - Fax:516-683-0892
Practice Address - Street 1:1600 STEWART AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6696
Practice Address - Country:US
Practice Address - Phone:516-683-0888
Practice Address - Fax:516-683-0892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental