Provider Demographics
NPI:1871685602
Name:KANTOR, EDWARD MORRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MORRIS
Last Name:KANTOR
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 1:28 1/2 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-1226
Mailing Address - Country:US
Mailing Address - Phone:315-673-3102
Mailing Address - Fax:315-673-2252
Practice Address - Street 1:28 1/2 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:NY
Practice Address - Zip Code:13108-1226
Practice Address - Country:US
Practice Address - Phone:315-673-3102
Practice Address - Fax:315-673-2252
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029733-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist