Provider Demographics
NPI:1639196082
Name:GARVER, ELAINE F (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:F
Last Name:GARVER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 N FOREST AVE
Mailing Address - Street 2:APT 2L
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5459
Mailing Address - Country:US
Mailing Address - Phone:516-764-4386
Mailing Address - Fax:516-764-4389
Practice Address - Street 1:371 MERRICK RD
Practice Address - Street 2:SUITE 304
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5359
Practice Address - Country:US
Practice Address - Phone:516-764-4386
Practice Address - Fax:516-764-4386
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050108-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice