Provider Demographics
NPI:1982709671
Name:GINZLER, BRADLEY M (DDS)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:GINZLER
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 1:1111 TAMARIND WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-5554
Mailing Address - Country:US
Mailing Address - Phone:561-684-1312
Mailing Address - Fax:
Practice Address - Street 1:1501 PRESIDENTIAL WAY
Practice Address - Street 2:#7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1800
Practice Address - Country:US
Practice Address - Phone:561-684-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN173751223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics