Provider Demographics
NPI:1336155142
Name:NORTH BELLMORE DENTAL ASSOCIATES PC
Entity Type:Organization
Organization Name:NORTH BELLMORE DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-221-2271
Mailing Address - Street 1:1179 NEWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1650
Mailing Address - Country:US
Mailing Address - Phone:516-221-2271
Mailing Address - Fax:516-221-6856
Practice Address - Street 1:1179 NEWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1650
Practice Address - Country:US
Practice Address - Phone:516-221-2271
Practice Address - Fax:516-221-6856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental