N.y. Dental Professional

NPI #1871793703 in NY, New York

Provider Information

NPI Number: 1871793703
Entity Type: Organization
Organization Name: N.y. Dental Professional
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 19, 2007
Last Updated: Jul 19, 2007

Practice Location

Address: 250 MERCER ST., B908
City: NY
State: New York
ZIP Code: 10012
Phone: (917) 952-7813

Authorized Official

Name: DR. JASON LIEM
Title: PRESIDENT
Phone: (917) 952-7813

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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