Provider Demographics
NPI:1225351281
Name:DR. ELI ADLER DDS PC
Entity Type:Organization
Organization Name:DR. ELI ADLER DDS PC
Other - Org Name:DENTAL ASSOCIATES OF LYNBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-255-1988
Mailing Address - Street 1:249 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3243
Mailing Address - Country:US
Mailing Address - Phone:516-255-1988
Mailing Address - Fax:516-255-1986
Practice Address - Street 1:249 BROADWAY
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3243
Practice Address - Country:US
Practice Address - Phone:516-255-1988
Practice Address - Fax:516-255-1986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0508031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty