Provider Demographics
NPI:1740308212
Name:KREITMAN, BRETT L (DMD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:L
Last Name:KREITMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DEAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670
Mailing Address - Country:US
Mailing Address - Phone:201-567-0707
Mailing Address - Fax:201-567-5230
Practice Address - Street 1:111 DEAN DRIVE
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670
Practice Address - Country:US
Practice Address - Phone:201-567-0707
Practice Address - Fax:201-567-5230
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13745122300000X
NJ13745NJ122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist