1447276282 NPI number — NEIL GANZ, D.D.S., P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447276282 NPI number — NEIL GANZ, D.D.S., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEIL GANZ, D.D.S., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447276282
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
440 S LINCOLN AVE
Provider Second Line Business Mailing Address:
SUITE B10
Provider Business Mailing Address City Name:
STEAMBOAT SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80487-8916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-879-5630
Provider Business Mailing Address Fax Number:
970-879-0703

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
440 S LINCOLN AVE
Provider Second Line Business Practice Location Address:
SUTIE B10
Provider Business Practice Location Address City Name:
STEAMBOAT SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80487-8916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-879-5630
Provider Business Practice Location Address Fax Number:
970-879-0703
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GANZ
Authorized Official First Name:
NEIL
Authorized Official Middle Name:
IRA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
970-879-5630

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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