# JACK LEVI DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720175912
- **Authorized official:** DR. JACK LEVI DDS (PRESIDENT)
- **Authorized official phone:** (201) 385-5400

## Contact information

- **Practice address:** 185 CEDAR LN, SUITE L7, TEANECK, NJ 07666-4316
- **Practice address phone:** (201) 385-5400
- **Mailing address:** 185 CEDAR LN, SUITE L7, TEANECK, NJ 07666-4316
- **Mailing address phone:** (201) 385-5400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 8340 | NJ | Yes |

## Other

- **Enumeration date:** 10/07/2006
- **Last updated:** 08/22/2020