Provider Demographics
NPI:1952319402
Name:CARNAZZA, GUY ERIC (DMD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:ERIC
Last Name:CARNAZZA
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 1:404 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1491
Mailing Address - Country:US
Mailing Address - Phone:516-887-3550
Mailing Address - Fax:
Practice Address - Street 1:9704 FLATLANDS AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236
Practice Address - Country:US
Practice Address - Phone:718-649-5678
Practice Address - Fax:718-272-2881
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0474811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice