Provider Demographics
NPI:1881853588
Name:EBERZ, JOHN PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:EBERZ
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 1:3811 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3434
Mailing Address - Country:US
Mailing Address - Phone:716-674-3737
Mailing Address - Fax:716-674-5725
Practice Address - Street 1:3811 SENECA ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3434
Practice Address - Country:US
Practice Address - Phone:716-674-3737
Practice Address - Fax:716-674-5725
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051138-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice