Provider Demographics
NPI:1962619445
Name:MORETZKY,, BARRY M (DMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:M
Last Name:MORETZKY,
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 1:295 MADISON AVE # 28FLR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6304
Mailing Address - Country:US
Mailing Address - Phone:212-697-2929
Mailing Address - Fax:212-697-0479
Practice Address - Street 1:295 MADISON AVE # 28FLR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6304
Practice Address - Country:US
Practice Address - Phone:212-697-2929
Practice Address - Fax:212-697-0479
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist