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Individual
DR. JASON TAN
Active
Individual
DR. JASON TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
057483
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
057483
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
306840
NY
Other
Enumeration date
07/02/2013
Last updated
08/14/2022
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