Provider Demographics
NPI:1184885709
Name:MESSINGER, BETH ERICA BROTH (DDS)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:ERICA BROTH
Last Name:MESSINGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BRYANT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1139
Mailing Address - Country:US
Mailing Address - Phone:516-621-7566
Mailing Address - Fax:
Practice Address - Street 1:55 BRYANT AVE STE 1
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1139
Practice Address - Country:US
Practice Address - Phone:516-621-7566
Practice Address - Fax:516-621-0385
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052804-11223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice