Jan Wade Gilbert Dmd PC
Dentist, General Practice in Lawrence, NY. Organization (NPI-2).
NPI number1386971968
StatusActive
Last updated in NPPESNov 3, 2009
Details
- NPI
- 1386971968
- Entity type
- Organization (NPI-2)
- Legal business name
- Jan Wade Gilbert Dmd PC
- Organization subpart
- No
- Enumeration date
- Nov 3, 2009
- Last updated
- Nov 3, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 029102 | NY | Yes |
Practice location
176 BroadwayLawrence, NY 11559-1731
Phone 516-239-3333
Mailing address
176 BroadwayLawrence, NY 11559-1731
Phone 516-239-3333
Authorized official
Jan Wade Gilbert
Owner
5162393333
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