Provider Demographics
NPI:1366405755
Name:ORT, HAROLD DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:DAVID
Last Name:ORT
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 1:1737 YORK AVE
Mailing Address - Street 2:STE 1A
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6841
Mailing Address - Country:US
Mailing Address - Phone:212-534-3020
Mailing Address - Fax:212-534-4071
Practice Address - Street 1:1737 YORK AVE
Practice Address - Street 2:STE 1A
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10128-6841
Practice Address - Country:US
Practice Address - Phone:212-534-3020
Practice Address - Fax:212-534-4071
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035107122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist