Provider Demographics
NPI:1720098635
Name:GURIN, MARK ISAAK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ISAAK
Last Name:GURIN
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 1:116 EAST 66TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6547
Mailing Address - Country:US
Mailing Address - Phone:212-988-8349
Mailing Address - Fax:212-988-0296
Practice Address - Street 1:116 E 66TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6547
Practice Address - Country:US
Practice Address - Phone:212-988-8349
Practice Address - Fax:212-988-0296
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0340571122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist