Provider Demographics
NPI:1386951549
Name:VLADISLAV GERTS DDS PC
Entity type:Organization
Organization Name:VLADISLAV GERTS DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-638-6002
Mailing Address - Street 1:743 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4503
Mailing Address - Country:US
Mailing Address - Phone:718-638-6002
Mailing Address - Fax:718-638-7085
Practice Address - Street 1:743 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4503
Practice Address - Country:US
Practice Address - Phone:718-638-6002
Practice Address - Fax:718-638-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty