Provider Demographics
NPI:1710100516
Name:GANZ, CARY HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:HOWARD
Last Name:GANZ
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 1:300 GARDEN CITY PLZ STE 212
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3330
Mailing Address - Country:US
Mailing Address - Phone:516-741-1230
Mailing Address - Fax:
Practice Address - Street 1:300 GARDEN CITY PLZ STE 212
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3330
Practice Address - Country:US
Practice Address - Phone:516-741-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDDS0286881223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics