Provider Demographics
NPI:1942382486
Name:MENZIES, GERARD H (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:H
Last Name:MENZIES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 N JERUSALEM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1100
Mailing Address - Country:US
Mailing Address - Phone:516-783-7151
Mailing Address - Fax:516-783-7164
Practice Address - Street 1:2570 N JERUSALEM RD
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1100
Practice Address - Country:US
Practice Address - Phone:516-783-7151
Practice Address - Fax:516-783-7164
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0405751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice