Provider Demographics
NPI:1851679534
Name:GENTLE FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:GENTLE FAMILY DENTISTRY, P.C.
Other - Org Name:MARGARITA FISHKIN, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-781-1100
Mailing Address - Street 1:128 FORT WASHINGTON AVE APT K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4735
Mailing Address - Country:US
Mailing Address - Phone:212-781-1100
Mailing Address - Fax:212-208-4315
Practice Address - Street 1:128 FORT WASHINGTON AVE APT K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4735
Practice Address - Country:US
Practice Address - Phone:212-781-1100
Practice Address - Fax:212-208-4315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045567-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty