Provider Demographics
NPI:1669655098
Name:SADOWSKY, MARC SAMUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:SAMUEL
Last Name:SADOWSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 E 29 ST
Mailing Address - Street 2:
Mailing Address - City:BKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210
Mailing Address - Country:US
Mailing Address - Phone:718-258-2462
Mailing Address - Fax:718-338-8689
Practice Address - Street 1:1134 E 29 ST
Practice Address - Street 2:
Practice Address - City:BKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210
Practice Address - Country:US
Practice Address - Phone:718-258-2462
Practice Address - Fax:718-338-8689
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04243511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice