Provider Demographics
NPI:1215102348
Name:STENZ, GORDON JEROME (DMD)
Entity type:Individual
Prefix:DR
First Name:GORDON
Middle Name:JEROME
Last Name:STENZ
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 1:26 GROVER LN
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7948
Mailing Address - Country:US
Mailing Address - Phone:973-226-0060
Mailing Address - Fax:
Practice Address - Street 1:26 GROVER LN
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7948
Practice Address - Country:US
Practice Address - Phone:973-226-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI013019001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice