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1730467564
JORDAN LISSAUER
STATEN ISLAND, NY
NPI
1730467564
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: NY 055112)
Enumeration Date
2011-07-27
Last Update Date
2020-04-06
Business Address
JORDAN LISSAUER DMD
3767 HYLAN BLVD
STATEN ISLAND, NY 10308-3505
Phone number: 718-966-2720
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Mailing Address
JORDAN LISSAUER DMD
3767 HYLAN BLVD
STATEN ISLAND, NY 10308-3505
Phone number:
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