| NPI | 1760452106 |
|---|---|
| Doing Business As | JACKSON HEIGHTS DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MARK DAVID LORBER Owner 718-651-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 047347) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 046409) |
| 1223G0001X Dentist, General Practice (Licence: NY 052071) | |
| 1223P0300X Dentist, Periodontics (Licence: NY 047303) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2020-08-22 |