Provider Demographics
NPI:1508024365
Name:GLUSKIN, MICHAEL B (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:GLUSKIN
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2272 HENDRICKSON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5131
Mailing Address - Country:US
Mailing Address - Phone:718-253-3333
Mailing Address - Fax:718-377-1452
Practice Address - Street 1:2272 HENDRICKSON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5131
Practice Address - Country:US
Practice Address - Phone:718-253-3333
Practice Address - Fax:718-377-1452
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308401223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics