Provider Demographics
NPI:1568454460
Name:SAFRAN, BRUCE H (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:H
Last Name:SAFRAN
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 1:53 STONE HILL DR S
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-4427
Mailing Address - Country:US
Mailing Address - Phone:516-869-6688
Mailing Address - Fax:516-869-6686
Practice Address - Street 1:53 STONE HILL DR S
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-4427
Practice Address - Country:US
Practice Address - Phone:516-869-6688
Practice Address - Fax:516-869-6686
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY328131223G0001X
NJ22DI011433001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice