Provider Demographics
NPI:1649312182
Name:POMERANTZ, JEFFREY MARTIN (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MARTIN
Last Name:POMERANTZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:521 5TH AVE
Mailing Address - Street 2:SUITE #819
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10175-0003
Mailing Address - Country:US
Mailing Address - Phone:212-697-3999
Mailing Address - Fax:212-697-9839
Practice Address - Street 1:521 5TH AVE
Practice Address - Street 2:SUITE #819
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10175-0003
Practice Address - Country:US
Practice Address - Phone:212-697-3999
Practice Address - Fax:212-697-9839
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32497-11223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics