Provider Demographics
NPI:1427352111
Name:EARL S DORFMAN DDS PC
Entity type:Organization
Organization Name:EARL S DORFMAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:REID
Authorized Official - Last Name:DORFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-334-4848
Mailing Address - Street 1:530 OLD COUNTRY ROAD
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4500
Mailing Address - Country:US
Mailing Address - Phone:516-334-4848
Mailing Address - Fax:516-333-4747
Practice Address - Street 1:530 OLD COUNTRY RD
Practice Address - Street 2:SUITE 2F
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-4500
Practice Address - Country:US
Practice Address - Phone:516-334-4848
Practice Address - Fax:516-333-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty