Provider Demographics
NPI:1013128966
Name:SAPIENZA, GARY G (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:G
Last Name:SAPIENZA
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 1:311 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2621
Mailing Address - Country:US
Mailing Address - Phone:856-662-6152
Mailing Address - Fax:856-665-1264
Practice Address - Street 1:311 E MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2621
Practice Address - Country:US
Practice Address - Phone:856-662-6152
Practice Address - Fax:856-665-1264
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ150801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice