Provider Demographics
NPI:1467503946
Name:GARTH DENTAL, P.C.
Entity type:Organization
Organization Name:GARTH DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHANOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-472-4677
Mailing Address - Street 1:281 GARTH RD
Mailing Address - Street 2:SUITE #B1J
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4052
Mailing Address - Country:US
Mailing Address - Phone:914-472-4677
Mailing Address - Fax:914-722-0312
Practice Address - Street 1:281 GARTH RD
Practice Address - Street 2:SUITE #B1J
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4052
Practice Address - Country:US
Practice Address - Phone:914-472-4677
Practice Address - Fax:914-722-0312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044721A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty