Provider Demographics
NPI:1447469259
Name:OELBAUM, VICTOR (DDS)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:OELBAUM
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 1:2335 EASTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5910
Mailing Address - Country:US
Mailing Address - Phone:718-882-7202
Mailing Address - Fax:718-882-2869
Practice Address - Street 1:2335 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5910
Practice Address - Country:US
Practice Address - Phone:718-882-7202
Practice Address - Fax:718-882-2869
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY38821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist