Provider Demographics
NPI:1720133366
Name:GARBER, JEFFREY G (DMD, MBE, LLC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:G
Last Name:GARBER
Suffix:
Gender:M
Credentials:DMD, MBE, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E CITY LINE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1115
Mailing Address - Country:US
Mailing Address - Phone:610-667-0211
Mailing Address - Fax:610-667-0229
Practice Address - Street 1:555 E CITY LINE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1115
Practice Address - Country:US
Practice Address - Phone:610-667-0211
Practice Address - Fax:610-667-0229
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017676L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice