Jessica N Madrid Dentistry P.C.
Clinic/Center, Dental in Lynbrook, NY. Organization (NPI-2).
NPI number1114595352
StatusActive
Last updated in NPPESJun 15, 2021
Details
- NPI
- 1114595352
- Entity type
- Organization (NPI-2)
- Legal business name
- Jessica N Madrid Dentistry P.C.
- Organization subpart
- No
- Enumeration date
- Jun 15, 2021
- Certification date
- Jun 13, 2021
- Last updated
- Jun 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
4 Whittier StLynbrook, NY 11563-1018
Phone 516-754-0430
Mailing address
4 Whittier StLynbrook, NY 11563-1018
Phone 516-754-0430
Authorized official
Jessica N Madrid
Doctor/President
5167540430
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