Provider Demographics
NPI:1336356609
Name:GARTENBERG, JAMIE SETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:SETH
Last Name:GARTENBERG
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 1:2333 N TRIPHAMMER RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1082
Mailing Address - Country:US
Mailing Address - Phone:607-257-0539
Mailing Address - Fax:
Practice Address - Street 1:2333 N TRIPHAMMER RD
Practice Address - Street 2:SUITE 502
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1082
Practice Address - Country:US
Practice Address - Phone:607-257-0539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0460521223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics