Provider Demographics
NPI:1861669616
Name:LEMAITRE, BRONISLAW B (DDS)
Entity Type:Individual
Prefix:
First Name:BRONISLAW
Middle Name:B
Last Name:LEMAITRE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:BRONISLAW
Other - Middle Name:
Other - Last Name:LEMAITRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:896 MANHATTAN AVE
Mailing Address - Street 2:RM.3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2372
Mailing Address - Country:US
Mailing Address - Phone:718-389-6354
Mailing Address - Fax:
Practice Address - Street 1:896 MANHATTAN AVE
Practice Address - Street 2:RM.3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2372
Practice Address - Country:US
Practice Address - Phone:718-389-6354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041781122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist