Provider Demographics
NPI:1548612369
Name:GFM DENTAL GROUP, PLLC
Entity Type:Organization
Organization Name:GFM DENTAL GROUP, PLLC
Other - Org Name:ONEDENT OF WESTCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-481-5733
Mailing Address - Street 1:3020 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2510
Mailing Address - Country:US
Mailing Address - Phone:914-481-5733
Mailing Address - Fax:914-481-5729
Practice Address - Street 1:3020 WESTCHESTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2510
Practice Address - Country:US
Practice Address - Phone:914-481-5733
Practice Address - Fax:914-481-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0438551223E0200X
NY0303241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty