Provider Demographics
NPI:1912124413
Name:MARKOWITZ, GERALD A (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:MARKOWITZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:GERALD
Other - Middle Name:A
Other - Last Name:MARKOWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:632 MONTGOMERY AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2031
Mailing Address - Country:US
Mailing Address - Phone:610-664-6061
Mailing Address - Fax:610-664-5293
Practice Address - Street 1:632 MONTGOMERY AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2031
Practice Address - Country:US
Practice Address - Phone:610-664-6061
Practice Address - Fax:610-664-5293
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS016765L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice