Provider Demographics
NPI:1578920260
Name:TANSKI, EDWARD A JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:A
Last Name:TANSKI
Suffix:JR
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 PLEASURE AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226
Mailing Address - Country:US
Mailing Address - Phone:609-335-6886
Mailing Address - Fax:
Practice Address - Street 1:162 HADDON AVE
Practice Address - Street 2:
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091
Practice Address - Country:US
Practice Address - Phone:856-767-7766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI007710001223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health